Basic Information
Provider Information
NPI: 1255956546
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAREDES
FirstName: MARIA CECILIA
MiddleName: UNAY
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 484 S MERIDIAN AVE
Address2:  
City: MADERA
State: CA
PostalCode: 936368365
CountryCode: US
TelephoneNumber: 5593552507
FaxNumber:  
Practice Location
Address1: 1303 E HERNDON AVE
Address2:  
City: FRESNO
State: CA
PostalCode: 937203309
CountryCode: US
TelephoneNumber: 5594503000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/11/2020
LastUpdateDate: 06/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X95014171CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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