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General NPI Number Information
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NPI Number | 1992472500
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Entity Type | Individual
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Provider Name | YANET ALICIA MEDINA CHINAS PA
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Gender | Female
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 450 LINCOLN AVE STE 101
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City | SALINAS
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State | CA
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Zip | 93901-2652
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Country | US
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Telephone | 831-269-5288
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Fax |
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Provider Business Mailing Address
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Address Line | 608 ROWLETT RD APT 515
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City | GARLAND
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State | TX
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Zip | 75043-3703
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Country | US
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Telephone | 907-885-8414
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA14695
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA63784
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License Number State | CA
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