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NPI Code Detail

MEDICARE: MEDINA FAHIM

MEDICARE: MEDINA FAHIM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1629935721
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEDINA FAHIM
Provider Business Mailing Address
First Line : 3419 VALLE VERDE DR
Second Line :
City : NAPA
State : CA
Zip : 94558-2414
Country : US
Telephone Number : 707-299-8250
Fax Number : 707-635-8215
Provider Business Practice Location Address
First Line : 3419 VALLE VERDE DR
Second Line :
City : NAPA
State : CA
Zip : 94558-2414
Country : US
Telephone Number : 707-299-8250
Fax Number : 707-635-8215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/08/2026

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Directions to “ MEDINA FAHIM ” Practice Location

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