Individual
MS. SANDRA ANGELICA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 E DEL MAR BLVD, PASADENA, CA 91107-4375
(626) 795-9901
(626) 356-2503
Mailing address
250 N HAMBLEDON AVE, LA PUENTE, CA 91744-5323
(626) 581-8684
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40294
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/01/2007
Last updated
02/08/2019
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