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Individual
AUDREY MORENO MEDINA
Active
Individual
AUDREY MORENO MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
141738
CA
106H00000X
Marriage & Family Therapist
Primary
163590
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952562910
PSYCHOTHERAPY
CA
Enumeration date
07/28/2022
Last updated
06/14/2026
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