# MARY PARADIS PROFESSIONAL NURSING PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639068893
- **Authorized official:** MARY PARADIS (PRESIDENT & CEO)
- **Authorized official phone:** (661) 677-9098

## Contact information

- **Practice address:** 21990 HILLSIDE DR, PALO CEDRO, CA 96073-8637
- **Practice address phone:** (661) 677-9098
- **Mailing address:** 21990 HILLSIDE DR, PALO CEDRO, CA 96073-8637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2025
- **Last updated:** 07/01/2025