Provider Demographics
NPI:1215719018
Name:PAREDES, CHRISTIAN JAVIER
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:JAVIER
Last Name:PAREDES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CHRISTIAN
Other - Middle Name:JAVIER
Other - Last Name:PAREDESCAICEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6237 NOROCO DR
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-3412
Mailing Address - Country:US
Mailing Address - Phone:562-587-0919
Mailing Address - Fax:
Practice Address - Street 1:6237 NOROCO DR
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-3412
Practice Address - Country:US
Practice Address - Phone:562-587-0919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1161091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical