Individual
DESIREE MEDINA I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2275 ARLINGTON DR, SAN LEANDRO, CA 94578-1132
(510) 317-1444
Mailing address
2275 ARLINGTON DR, SAN LEANDRO, CA 94578-1132
(510) 317-1444
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
87365
CA
104100000X
Social Worker
Primary
87365
CA
1041C0700X
Clinical Social Worker
87365
CA
Other
Enumeration date
08/05/2015
Last updated
03/22/2024
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