DR. MILDRED MEDINA (NPI# 1386808194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386808194 |
| Entity Type | Individual |
| Full Name | DR. MILDRED MEDINA |
| Credential | PSYD |
| Practice Address |
23500 Kasson Rd Tracy CA 95376 |
| Mailing Address |
5203 18th Ave Ne Seattle WA 98105-3409 |
| Practice Telephone | 2098354141 |
| Practice Fax Number | 2098303974 |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2009-11-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY 60037300 | WA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY21221 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669765400 | Mildred Medina | Pharmacist | 4203 Calle Marginal, Fajardo, PR 00738-3652 | 2011-05-26 |
| Street Address |
23500 KASSON RD |
| City | TRACY |
| State | CA |
| Zip Code | 95376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942262845 | Craig Michael Lindner | Dentist | 23500 Kasson Rd, Deuel Vocational Institution, Tracy, CA 95304-9518 | 2006-04-05 |
| 1467995704 | Vincent Tran | Pharmacist | 23500 Kasson Rd, Room 106 (pharmacy), Tracy, CA 95376-0400 | 2016-11-18 |
| 1053709600 | Taylor Johnson | Counselor | 23500 Kasson Rd, Tracy, CA 95304-9595 | 2015-01-06 |
| 1831505809 | Frederick Curtis | Physician Assistant | 23500 Kasson Rd, Tracy, CA 95378 | 2014-07-10 |
| 1215277207 | Dawn Bramley | Psychologist | 23500 Kasson Rd, Tracy, CA 95304 | 2013-02-27 |
| 1912265539 | Mimi Ngoc Vo | Pharmacist | 23500 Kasson Rd, Tracy, CA 95376 | 2012-05-02 |
| 1073870150 | Grant Joel Franceschi | Psychologist | 23500 Kasson Rd, Tracy, CA 95378 | 2012-04-13 |
| 1679800627 | Martin Henry Jansen | Psychiatry & Neurology | 23500 Kasson Rd, Tracy, CA 95378 | 2009-11-12 |
| 1083801542 | Paul Malarik Jr. | Psychiatry & Neurology | 23500 Kasson Rd, Mental Health, Tracy, CA 95376 | 2007-09-28 |
| 1780875476 | Pashtoon H Safi | Physician Assistant | 23500 Kasson Rd, Tracy, CA 95376 | 2007-08-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932757150 | James Burgess Angel | Technician, Other | 455 W. Eaton Ave., Tracy, CA 95376 | 2019-08-30 |
| 1477079655 | Cassandra Sierra | Specialist/Technologist | 632 W 11th St Ste 119, Tracy, CA 95376 | 2017-08-18 |
| 1922465491 | Jasmeer Kaur Uppal | Registered Nurse | 1411 N. Tracy Bl., Tracy, CA 95376 | 2016-01-28 |
| 1679957773 | Amy Forester | Physical Therapy Assistant | 1752 Schantz Way, Tracy, CA 95376 | 2015-07-17 |
| 1477966265 | Sarah Ojeda | Marriage & Family Therapist | 19 East 6th Street, Tracy, CA 95376 | 2014-06-09 |
| 1356761209 | Lucille Nowakowski | Registered Nurse | 95 West 11 Th St, Tracy, CA 95376 | 2014-04-18 |
| 1821417718 | Ricardo Echon | Nurse Practitioner | 644 W 12th Street, Tracy, CA 95376 | 2014-04-08 |
| 1508105354 | Sutter Central Valley Hospitals | Pharmacy | 1420 N. Tracy Blvd., Tracy, CA 95376 | 2013-02-13 |
| 1790034056 | Amy Powers | Counselor | 902 N Central Ave Ste 308, Tracy, CA 95376 | 2012-09-02 |
| 1982951554 | Gurpreet Singh Dhaliwal Md Inc. | Anesthesiology | 1530 Bessie Ave Ste 104, Tracy, CA 95376 | 2012-08-13 |
| Find all providers in zip 95376 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730530460 | Dr. Speed, Inc. | Psychologist | 672 W 11th St Ste 100, Tracy, CA 95376-3821 | 2016-06-23 |
| 1821412974 | Carol Roberta Anderson | Psychologist | 23500 Kasson Rd., Tracy, CA 95378-0400 | 2014-02-10 |
| 1346372950 | Erin K Sicard | Psychologist | 1660 W Linne Rd Ste J25, Tracy, CA 95377-8024 | 2007-03-09 |
| 1326174913 | Roger James Carey | Psychologist | 652 W 11th St Ste 133, Tracy, CA 95376-3869 | 2007-02-26 |
| 1215277207 | Dawn Bramley | Psychologist | 23500 Kasson Rd, Tracy, CA 95304 | 2013-02-27 |
| 1073870150 | Grant Joel Franceschi | Psychologist | 23500 Kasson Rd, Tracy, CA 95378 | 2012-04-13 |
| 1649504259 | Tripti Bawari | Psychologist | 672 W 11th St, Suite 317, Tracy, CA 95376-3821 | 2009-09-29 |
| 1467786079 | Patrick Victor Faggianelli Jr. | Psychologist | 227 E 11th St, Tracy, CA 95376-4015 | 2009-09-29 |
| 1336202597 | Carol Kocke Caruso | Psychologist | 445 W Beverly Pl, Tracy, CA 95376 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023867 | Watson, Sanchez, & Navarro Psychological Group | Psychologist | 270 E 7th St Ste 1c, Upland, CA 91786-6602 | 2020-11-08 |
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1982203568 | Gautami Polepally Ashok | Psychologist | 1234 W Chapman Ave Ste 203, Orange, CA 92868-2863 | 2020-10-23 |
| 1851990626 | Sarah R Martin | Psychologist | 650 Charles E Young Dr S # 12-096, Los Angeles, CA 90095-8347 | 2020-10-22 |
| 1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
| 1588261580 | Pamela J Newman | Psychologist | 3737 Elderberry Gln, Escondido, CA 92025-7910 | 2020-10-04 |
| 1689271785 | Michelle Sullivan | Psychologist | 2419 44th Ave, San Francisco, CA 94116-2062 | 2020-10-02 |
| 1184231730 | Joanna Lesley Kaye | Psychologist | 3555 Rosecrans St Ste 114-212, San Diego, CA 92110-3231 | 2020-09-28 |
| 1174130181 | Pamela F. Benyas | Psychologist | Dr. Pamela Benyas, 4419 Vans Nuys Bl #400, Sherman Oaks, CA 91403 | 2020-09-24 |
| 1730795634 | Maya Boustani | Psychologist | 5441 Dundee Ct, Rancho Cucamonga, CA 91739-2604 | 2020-09-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.