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NPI Code Detail

MEDICARE: MEREDITH ELENA MEDIN LMFT

MEDICARE: MEREDITH ELENA MEDIN LMFT
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
1106H00000XMarriage & Family Therapist49971CA

General Provider Information

NPI Number : 1508991746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEREDITH ELENA MEDIN LMFT
Provider Business Mailing Address
First Line : 5330 SAN BERNARDINO ST
Second Line :
City : MONTCLAIR
State : CA
Zip : 91763-2952
Country : US
Telephone Number : 866-205-3595
Fax Number :
Provider Business Practice Location Address
First Line : 5330 SAN BERNARDINO ST
Second Line :
City : MONTCLAIR
State : CA
Zip : 91763-2952
Country : US
Telephone Number : 866-205-3595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 10/29/2024

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Directions to “ MEREDITH ELENA MEDIN LMFT” Practice Location

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