Individual
PRISCILLA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1030 W WARNER AVE, SANTA ANA, CA 92707-3147
(714) 546-6450
Mailing address
6831 RED COACH DR, HUNTINGTON BEACH, CA 92647-2956
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48857
CA
Other
Enumeration date
09/18/2017
Last updated
09/18/2017
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