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Individual

JOHANNA MEDINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
43825 46TH ST W, LANCASTER, CA 93536-2365
(406) 696-6766
Mailing address
43825 46TH ST W, LANCASTER, CA 93536-2365
(406) 696-6766

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
837431
CA

Other

Enumeration date
07/16/2019
Last updated
07/16/2019
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