Individual
CHANTAL C MEDEIROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12505 LA GALLINA AVE, WATERFORD, CA 95386-9701
(209) 517-6107
Mailing address
12505 LA GALLINA AVE, WATERFORD, CA 95386-9701
(209) 517-6107
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
CA
Other
Enumeration date
03/30/2026
Last updated
03/30/2026
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