Provider Demographics
NPI:1487453122
Name:PAREDES, LUIS FERNANDO JR (COTA/L)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:FERNANDO
Last Name:PAREDES
Suffix:JR
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10024 BELCHER ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-5006
Mailing Address - Country:US
Mailing Address - Phone:562-677-4555
Mailing Address - Fax:
Practice Address - Street 1:1835 W LA VETA AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4132
Practice Address - Country:US
Practice Address - Phone:714-978-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA6554224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant