Healthcare Provider Details

I. General information

NPI: 1336940972
Provider Name (Legal Business Name): PAULINA PAREDES CIENEGA M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 WILSHIRE BLVD STE 500
LOS ANGELES CA
90010-1427
US

IV. Provider business mailing address

4600 N CLARENDON AVE APT 1012
CHICAGO IL
60640-5761
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-2350
  • Fax:
Mailing address:
  • Phone: 323-649-2066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: