Individual
ANDREA ROSEMARY MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
714 W MAIN ST, GRASS VALLEY, CA 95945-6410
(530) 477-9800
Mailing address
PO BOX 266, ELMIRA, CA 95625-0266
(707) 365-2847
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMF 67037
CA
Other
Enumeration date
02/22/2013
Last updated
11/19/2019
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