Medina, Mildred
Medina, Mildred is an sole proprietor health care provider with primary practice located at 23500 Kasson Rd , Tracy CA 95376. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Medina, Mildred can be contacted via phone (209) 835-4141.Contact Information
Primary practice address
23500 Kasson Rd
Tracy CA 95376
Phone: (209) 835-4141
Fax: (209) 830-3974
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY21221 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PY 60037300 | Washington |
Profile Details
| NPI number | 1386808194 |
|---|---|
| LBN Legal business name | Medina, Mildred |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 11th, 2008 |
| Last updated | Nov 2nd, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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