Individual
LADONNA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCEP
Contact information
Practice address
1409 GEORGIA ST, VALLEJO, CA 94590-5705
(707) 310-0863
Mailing address
1409 GEORGIA ST, VALLEJO, CA 94590-5705
(707) 310-0863
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
224Y00000X
Clinical Exercise Physiologist
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
03/10/2024
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