Provider Demographics
NPI:1346852720
Name:PORCAYO-PAREDES, NOELY (ASW)
Entity Type:Individual
Prefix:
First Name:NOELY
Middle Name:
Last Name:PORCAYO-PAREDES
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:NOELY
Other - Middle Name:
Other - Last Name:PAREDES-AGUILERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1260 N DUTTON AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-7121
Mailing Address - Country:US
Mailing Address - Phone:707-568-2300
Mailing Address - Fax:707-568-2304
Practice Address - Street 1:480 TESCONI CIR STE A
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4691
Practice Address - Country:US
Practice Address - Phone:707-206-7268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health