STEPHANIE MEDINA (NPI# 1679044143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679044143 |
| Entity Type | Individual |
| Full Name | STEPHANIE MEDINA |
| Practice Address |
2020 Standiford Ave Ste F3 Modesto CA 95350-6531 |
| Mailing Address |
505 Poppy Ave Patterson CA 95363-9300 |
| Practice Telephone | 2097020139 |
| Mailing Telephone | 2095056178 |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2019-05-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 942378380 | 05 | |
| CA | 94-2378380 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093313033 | Stephanie Lyn Medina | Licensed Practical Nurse | 2349 N 83rd Dr, Phoenix, AZ 85037-3742 | 2020-10-13 |
| 1760869358 | Stephanie Medina | Emergency Medicine | 2600 Clifton Ave, Cincinnati, OH 45220-2872 | 2015-05-03 |
| 1164998092 | Stephanie Medina | Social Worker | 301 Broadway, Chelsea, MA 02150-2807 | 2018-10-18 |
| 1750868022 | Stephanie Medina | Occupational Therapy Assistant | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2018-07-19 |
| 1528562402 | Stephanie Medina | Behavior Technician | 2989 Broadmoor Valley Rd Ste D, Colorado Springs, CO 80906-4403 | 2018-03-23 |
| 1528568250 | Stephanie Medina | Occupational Therapy Assistant | 712 N Monroe Ave, Sedgwick, KS 67135-9492 | 2018-02-19 |
| 1609320571 | Stephanie Medina | Specialist/Technologist | 1936 North St, Nacogdoches, TX 75965-3940 | 2016-08-09 |
| 1205088069 | Stephanie E Medina | Counselor | 920 W Broadway St, Hobbs, NM 88240-5529 | 2008-10-10 |
| Street Address |
2020 STANDIFORD AVE STE F3 |
| City | MODESTO |
| State | CA |
| Zip Code | 95350-6531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942534110 | Mary Soua Vang | Counselor | 2020 Standiford Ave Ste F3, Modesto, CA 95350-6531 | 2009-09-21 |
| 1235788431 | Robert Perez | Counselor | 2020 Standiford Ave Ste F3, Modesto, CA 95350-6531 | 2019-09-10 |
| 1528625043 | Maria Gisselle Salaiza-araiza | Case Manager/Care Coordinator | 2020 Standiford Ave Ste F3, Modesto, CA 95350-6531 | 2019-05-20 |
| 1326583097 | Michelle Cordoba | Counselor | 2020 Standiford Ave Ste F3, Modesto, CA 95350-6531 | 2017-01-04 |
| 1033565148 | Karissa Lopez | Counselor | 2020 Standiford Ave Ste F3, Modesto, CA 95350-6531 | 2016-05-06 |
| 1639592702 | Jeffery Boney | Case Manager/Care Coordinator | 2020 Standiford Ave Ste F3, Modesto, CA 95350-6531 | 2014-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
| 1588211254 | Karla Junuen Toscano | Licensed Vocational Nurse | 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 | 2019-08-19 |
| 1831694769 | Loretta Myers-weber | Nurse Practitioner | 1510 Florida Ave Ste A, Modesto, CA 95350 | 2018-03-23 |
| 1720599632 | Coral Alejandra Amador | Counselor | 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 | 2017-10-18 |
| 1053820522 | Pannu and Henne Dental Corp. | Dentist | 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 | 2017-09-27 |
| 1346779709 | Kevin Sotelo | Behavior Technician | 2630 W Rumble Road, Modesto, CA 95350 | 2017-06-08 |
| 1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
| 1356881163 | Brady S Marshall | Dentist | 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 | 2017-02-27 |
| 1750755476 | Caremore Health Plan | Nurse Practitioner | 1234 Mchenry Avenue, Modesto, CA 95350 | 2015-11-18 |
| Find all providers in zip 95350 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043845357 | Anthony Rodriguez Contreras | Counselor | 2360 Scenic Dr, Modesto, CA 95355-4505 | 2020-03-06 |
| 1821567645 | Aricka Ream | Counselor | 1704 Groveton Way, Modesto, CA 95355-1904 | 2018-11-21 |
| 1831668466 | Palepa Iulio | Counselor | 3005 Cannon Way Apt A, Modesto, CA 95354-2155 | 2018-11-13 |
| 1104364801 | Catherine Mae Linville | Counselor | 1030 15th St, Modesto, CA 95354-1102 | 2017-02-02 |
| 1417492182 | Chaqulia Anita Ramirez | Counselor | 2020 Standiford Ave # Suitef3, Modesto, CA 95350-6529 | 2017-01-04 |
| 1588061337 | Ashley Boyd | Counselor | 1336 Stonum Rd, Modesto, CA 95351-5121 | 2014-11-21 |
| 1720482136 | Shari Johnson | Counselor | 1517 Panthers Ln, Modesto, CA 95355-9303 | 2014-10-14 |
| 1407126469 | Tommy Phoukhaothong Panyanouvong | Counselor | 1300 Payne Ave, Modesto, CA 95351-4821 | 2012-01-09 |
| 1740579424 | Milissa Ann Catherine-plett | Counselor | 108 Bonita Cir, Modesto, CA 95354-1410 | 2011-04-01 |
| 1205144318 | Brianna Decoteau | Counselor | 916 Mchenry, Modesto, CA 95350 | 2010-09-23 |
| Find all providers in MODESTO | ||||
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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.