Mildred Medina is a Clinical in Tracy, California. Mildred Medina practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mildred Medina is 1386808194. The last update date is 2009-11-02.
Mildred Medina's current location address is 23500 Kasson Rd, Tracy, California. You can contact this provider via phone number 2098354141 and fax number 2098303974. The mailing address for Mildred Medina is 23500 Kasson Rd, Tracy, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mildred Medina |
|---|---|
| Address | 23500 Kasson Rd, Tracy, California |
| Phone Number | 2098354141 |
| Fax Number | 2098303974 |
| Sole Proprietor | Y |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1386808194 |
|---|---|
| Provider Enumeration Date | 2008-07-11 |
| Last Updated Date | 2009-11-02 |
Provider Mailing Address Detail
| Address | 23500 Kasson Rd |
|---|---|
| City | Tracy |
| State | California (CA) |
| Post Code | 95376 |
| Phone Number | 2098354141 |
| Fax Number | 2098303974 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY21221 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique identifier code issued to Mildred Medina by the Centers for Medicare & Medicaid Services?
The Mildred Medina has been assigned the NPI (National Provider Identifier) 1386808194. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Mildred Medina's facilities are geographically located?
The facilities of Mildred Medina are physically situated at the following location: 23500 Kasson Rd, Tracy, CA, 95376.
What is the Mildred Medina's specialty and taxonomy code?
The Mildred Medina's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1386808194 to Mildred Medina?
The Mildred Medina received its 1386808194 assignment from the Centers for Medicare & Medicaid Services on 2008-07-11.
When was the information related to Mildred Medina most recently updated or refreshed?
The details pertaining to the Mildred Medina, including its address, specialty, and other relevant information, were last updated or refreshed on 2009-11-02.
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