Individual
ATHENA M MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24301 SOUTHLAND DR STE 510, HAYWARD, CA 94545-1540
(925) 915-0610
Mailing address
1410 MARSHALL ST, REDWOOD CITY, CA 94063-2503
(650) 373-0777
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/05/2021
Last updated
04/25/2023
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