Provider Demographics
NPI:1043834906
Name:PAREDES, CLARO ACIO (MA)
Entity Type:Individual
Prefix:MR
First Name:CLARO
Middle Name:ACIO
Last Name:PAREDES
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 HUNTINGTON DR # 353
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2400
Mailing Address - Country:US
Mailing Address - Phone:626-422-5325
Mailing Address - Fax:
Practice Address - Street 1:17777 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3736
Practice Address - Country:US
Practice Address - Phone:213-908-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117396101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health