Provider Demographics
NPI:1073332953
Name:PAZ PARAMO, ESTRELLA MENDOZA
Entity type:Individual
Prefix:
First Name:ESTRELLA
Middle Name:MENDOZA
Last Name:PAZ PARAMO
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 1:8351 LANCRAFT DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5832
Mailing Address - Country:US
Mailing Address - Phone:916-504-0882
Mailing Address - Fax:916-228-4262
Practice Address - Street 1:8351 LANCRAFT DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5832
Practice Address - Country:US
Practice Address - Phone:916-504-0882
Practice Address - Fax:916-228-4262
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA342701338310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility