Healthcare Provider Details

I. General information

NPI: 1952661555
Provider Name (Legal Business Name): NADIA FERNANDA PAREDES MFT INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 05/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W CESAR E CHAVEZ AVE SUITE 201
LOS ANGELES CA
90012-2104
US

IV. Provider business mailing address

8051 LINCOLN BLVD APT. 5
LOS ANGELES CA
90045-2437
US

V. Phone/Fax

Practice location:
  • Phone: 213-217-5300
  • Fax: 213-217-5396
Mailing address:
  • Phone: 310-597-7515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: