Healthcare Provider Details

I. General information

NPI: 1235559246
Provider Name (Legal Business Name): MARIA JOSEPHINE EDU TUYA-PAREDES CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 N STATE ST
SAN JACINTO CA
92583-6567
US

IV. Provider business mailing address

621 N STATE ST
SAN JACINTO CA
92583-6567
US

V. Phone/Fax

Practice location:
  • Phone: 951-654-4044
  • Fax:
Mailing address:
  • Phone: 951-654-4044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number95000213
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: