Individual
BRANDI MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(971) 206-6337
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207QA0505X
Adult Medicine Physician
Primary
0000000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
AETNA
TX
05
—
0000000000
—
TX
01
—
808409140860054
AETNA
—
Enumeration date
03/05/2020
Last updated
03/05/2020
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