IMELDA MEDINA (NPI# 1407456403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407456403 |
| Entity Type | Individual |
| Full Name | IMELDA MEDINA |
| Practice Address |
4920 Avalon Blvd Los Angeles CA 90011-4004 |
| Mailing Address |
3747 W 107th St Inglewood CA 90303-1933 |
| Practice Telephone | 3232355035 |
| Mailing Telephone | 3102136258 |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164X00000X | Licensed Vocational Nurse | 243336 | CA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972927424 | Imelda Medina | Licensed Vocational Nurse | 226 Alta Mesa Dr, South San Francisco, CA 94080-3002 | 2014-02-04 |
| Street Address |
4920 AVALON BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90011-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851439053 | Baart Behavioral Health Services, Inc | Clinic/Center | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2007-02-01 |
| 1336747153 | Patricia Flores | Counselor | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2020-10-14 |
| 1336786391 | Brenda Carrera | Counselor | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2019-12-09 |
| 1295386076 | Jordan Hoskin | Counselor | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2019-09-24 |
| 1912553074 | Tyresha Diana Ross | Counselor | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2019-08-14 |
| 1245719186 | Shannon Rose Cowie | Counselor | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2018-08-10 |
| 1356832646 | Miguel E Garcia-guevara | Counselor | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2018-05-23 |
| 1831695154 | Alma Caridad Duarte | Counselor | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2018-04-04 |
| 1649786807 | Irfana Patla | Counselor | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2017-12-22 |
| 1972013654 | Yolanda Renee Clemons | Student in an Organized Health Care Education/Training Program | 4920 Avalon Blvd, Los Angeles, CA 90011-4004 | 2017-10-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223935 | Commercial & Housing Support Aid | Assisted Living Facility | 120 - 122 East 24th Street, Los Angeles, CA 90011 | 2020-10-22 |
| 1295377711 | Joseph D Madrigal | Home Health Aide | 1977 Anzac Ave, Los Angeles, CA 90011 | 2019-10-16 |
| 1538641212 | Brenda Bahena | Community Health Worker | South Central Family Health Center, 4425 S. Central Ave, Los Angeles, CA 90011 | 2018-08-30 |
| 1083101851 | Bronwyn Anne Hazlewood | Student in an Organized Health Care Education/Training Program | 3740 Maple Ave, 1/2 B, Los Angeles, CA 90011 | 2018-04-17 |
| 1164941183 | Kimberly Denise Lister- Gutierrez | Counselor | 303 E 52nd Street, Los Angeles, CA 90011 | 2017-09-11 |
| 1205252533 | Jameese B Smith | Case Manager/Care Coordinator | 271 E. 43rd Street, Los Angeles, CA 90011 | 2014-03-11 |
| 1033533153 | Avalon-carver Community Center | Community/Behavioral Health | 4920 S. Avalon Blvd, Los Angeles, CA 90011 | 2014-02-10 |
| 1245672500 | Kellie D Bougard | Student in an Organized Health Care Education/Training Program | 4920 South Avalon Blvd, Los Angeles, CA 90011 | 2013-07-26 |
| 1578909404 | Ma. Jasmin F Binas | Nurse Practitioner | 2707 S.central Ave., Los Angeles, CA 90011 | 2013-05-19 |
| 1912343344 | California Assisted Pharmacy, Inc | Pharmacy | 646 E 28th St, Ste #1, Los Angeles, CA 90011 | 2013-05-13 |
| Find all providers in zip 90011 | ||||
| Taxonomy Code | 164X00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Vocational Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649878166 | Crystal Shin | Licensed Vocational Nurse | 3785 Wilshire Blvd Apt 1804, Los Angeles, CA 90010-2893 | 2020-10-16 |
| 1144833617 | Guadalupe Vallejo | Licensed Vocational Nurse | 515 Columbia Avenue, #200, 515 Columbia Avenue, Los Angeles, CA 90017 | 2020-08-25 |
| 1942829338 | Gabriela Contreras | Licensed Vocational Nurse | 1236 E 48th St, Los Angeles, CA 90011-4236 | 2020-04-15 |
| 1487273892 | Randolph Gentle | Licensed Vocational Nurse | 2751 W 14th St Apt B, Los Angeles, CA 90006-4315 | 2020-04-15 |
| 1033767199 | Martineata Carlisle | Licensed Vocational Nurse | 716 E 116th Pl, Los Angeles, CA 90059-2300 | 2019-08-30 |
| 1356999767 | Shemeka Germany | Licensed Vocational Nurse | 942 W 74th St, Los Angeles, CA 90044-5115 | 2019-08-28 |
| 1841846185 | Garey Faron Young | Licensed Vocational Nurse | 1573 W 48th St, Los Angeles, CA 90062-2029 | 2019-08-13 |
| 1720632888 | Tyonna Lashey Causer | Licensed Vocational Nurse | 10309 S Gramercy Pl, Los Angeles, CA 90047-4130 | 2019-07-27 |
| 1093375669 | Kathleen Anne Macapagal Alonzo | Licensed Vocational Nurse | 5088 Highland View Ave Apt 2, Los Angeles, CA 90041-2037 | 2019-06-17 |
| 1245799873 | Anisah I Seon | Licensed Vocational Nurse | 4043 Don Tomaso Dr Apt 4, Los Angeles, CA 90008-5325 | 2019-03-13 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90011 |
Please comment or provide details below to improve the information on IMELDA MEDINA.
| 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.