Individual provider Active NPI

Luis Fernando Paredes Jr., COTA/L

  • Occupational Therapy Assistant
  • Orange, CA
National Provider Identifier
1487453122
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA6554 Issued in CA
Practice address
1835 W la Veta Ave
Orange, CA 92868-4132
Phone
(714) 978-6800
NPI assigned
Mar 12, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA6554 CA Primary

Addresses

Primary practice location

1835 W la Veta Ave
Orange, CA 92868-4132

Mailing address

10024 Belcher St
Downey, CA 90242-5006
Phone (562) 677-4555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA6554CAMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1487453122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10024 BELCHER ST",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902425006",
            "telephone_number": "562-677-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684132",
            "telephone_number": "714-978-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAREDES",
        "first_name": "LUIS",
        "middle_name": "FERNANDO",
        "name_suffix": "Jr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA6554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.