Provider Demographics
NPI:1295112613
Name:PAREDES-PLAZA, LESLIE (FNP-C)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:PAREDES-PLAZA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:PAREDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:6015 N GOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-4020
Mailing Address - Country:US
Mailing Address - Phone:626-722-7073
Mailing Address - Fax:
Practice Address - Street 1:6015 N GOODWAY DR
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-4020
Practice Address - Country:US
Practice Address - Phone:626-722-7073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002244363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily