Individual
ELAINE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 WOODHOLLY CT, SAN JOSE, CA 95116-3151
(408) 691-1388
Mailing address
1016 WOODHOLLY CT, SAN JOSE, CA 95116-3151
(408) 691-1388
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
19103
CA
Other
Enumeration date
10/08/2018
Last updated
12/30/2021
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