Provider Demographics
NPI:1629698253
Name:PAREDES, GISELA REGALADO
Entity Type:Individual
Prefix:
First Name:GISELA
Middle Name:REGALADO
Last Name:PAREDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42135 10TH ST W STE 201
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-6093
Mailing Address - Country:US
Mailing Address - Phone:661-341-3800
Mailing Address - Fax:661-341-3810
Practice Address - Street 1:42135 10TH ST W STE 201
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-6093
Practice Address - Country:US
Practice Address - Phone:661-341-3800
Practice Address - Fax:661-341-3810
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016391363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily