Provider Demographics
NPI:1952661555
Name:PAREDES, NADIA FERNANDA (MFT INTERN)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:FERNANDA
Last Name:PAREDES
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8051 LINCOLN BLVD
Mailing Address - Street 2:APT. 5
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-2437
Mailing Address - Country:US
Mailing Address - Phone:310-597-7515
Mailing Address - Fax:
Practice Address - Street 1:701 W CESAR E CHAVEZ AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2104
Practice Address - Country:US
Practice Address - Phone:213-217-5300
Practice Address - Fax:213-217-5396
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist