Individual provider Active NPI

Lucy Paredes, PA-C

  • Physician Assistant
  • Garden Grove, CA
National Provider Identifier
1881977965
Registry record updated Apr 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21888 Issued in CA
Practice address
12665 Garden Grove Blvd
Suite 713
Garden Grove, CA 92843-1901
Phone
(714) 537-6595
NPI assigned
Sep 24, 2011
Last updated
Apr 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21888 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd
Suite 713
Garden Grove, CA 92843-1901

Mailing address

12665 Garden Grove Blvd
Suite 713
Garden Grove, CA 92843-1901
Phone (714) 537-6595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200430002391 CA Practitioner - Physician Assistant 2365872512 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA21888CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Strongkids Medical Group Inc CurrentSince Mar 1, 2020 Accepting new patients

Locations

1491 E La Palma Ave
Ste B
Anaheim, CA 92805
Phone (714) 535-3330

12665 Garden Grove Blvd
Ste 713
Garden Grove, CA 92843
Phone (714) 537-6595

2222 S Main St
Santa Ana, CA 92707
Phone (714) 436-9999

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1881977965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 713",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-537-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 713",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-537-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAREDES",
        "first_name": "LUCY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-24",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.