INGRID VERONICA MEDINA NPI 1265958565

NPI Information

NPI: 1265958565
Provider Name: INGRID VERONICA MEDINA
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
400 ESTUDILLO AVE STE 100
SAN LEANDRO, CA
ZIP 94577
Phone: (510) 352-9200
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Ingrid Veronica Medina is a mental health counselor in San Leandro, CA. Ingrid Veronica Medina NPI is 1265958565. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

400 ESTUDILLO AVE STE 100
SAN LEANDRO, CA
ZIP 94577-962
Phone: (510) 352-9200

The enumeration date for this NPI number is 8/17/2017 and was last updated on 3/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	84690	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	90903175D26028	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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