MS. SANDRA ANGELICA MEDINA (NPI# 1871795823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871795823 |
| Entity Type | Individual |
| Full Name | MS. SANDRA ANGELICA MEDINA |
| Practice Address |
2900 E Del Mar Blvd Pasadena CA 91107-4375 |
| Mailing Address |
250 N Hambledon Ave La Puente CA 91744-5323 |
| Practice Telephone | 6267959901 |
| Practice Fax Number | 6263562503 |
| Mailing Telephone | 6265818684 |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2019-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | 40294 | CA | Nursing Service Providers |
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1517 W Garvey Ave N, West Covina, CA 917902138 | 6269626061 | 6269624471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366942898 | Sandra Leticia Medina | Technician | 3011 English Oaks Blvd, Pearland, TX 77584-7000 | 2018-02-21 |
| 1528598141 | Sandra Medina | Behavior Technician | 3571 Sw 117th Ave Apt 205, Miami, FL 33175-1754 | 2017-06-15 |
| 1881884153 | Sandra Medina | Social Worker | 122 N 6th St, Custer, SD 57730-1647 | 2007-08-01 |
| 1205054152 | Sandra Lorena Medina | Counselor | 301 N Joe Wilson Rd Apt 1512, Cedar Hill, TX 75104-2341 | 2007-04-23 |
| 1568764421 | Sandra Ninoska Medina | Homemaker | 1905 Nw 82nd Ave, Doral, FL 33126-1011 | 2010-11-29 |
| 1437465606 | Sandra M Medina | Occupational Therapy Assistant | 400 W Washington Ave, Chrisman, IL 61924-1042 | 2010-08-26 |
| 1245360023 | Sandra Medina | Social Worker | 5150 E Pacific Coast Hwy, Suite 100, Long Beach, CA 90804-3312 | 2007-03-07 |
| 1164589636 | Sandra Elaine Medina I | Counselor | 2085 E Dakota Ave, Fresno, CA 93726-4804 | 2007-01-03 |
| Street Address |
2900 E DEL MAR BLVD |
| City | PASADENA |
| State | CA |
| Zip Code | 91107-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700843216 | Aurora Las Encinas, LLC | Psychiatric Hospital | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2006-04-27 |
| 1356953020 | Jordan Louise Royer | Registered Nurse | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2020-08-23 |
| 1356964340 | James Williams | Registered Nurse | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2020-05-25 |
| 1972139277 | Aleksandra Nikolich Kusina | Registered Nurse | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2020-03-18 |
| 1851924260 | John Galdino Cummings Jr. | Registered Nurse | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2020-02-14 |
| 1720618952 | Marie Felyn Esperanzate Llacuna | Registered Nurse | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2020-01-15 |
| 1710523832 | Glenn Gil Zoleta | Registered Nurse | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2019-11-25 |
| 1023653870 | Julie M Crenshaw | Social Worker | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2019-11-14 |
| 1639713605 | Cecilia Enriqueta Que | Registered Nurse | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2019-11-03 |
| 1184266793 | Esther Hicks | Licensed Psychiatric Technician | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2019-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801412002 | Kwasi Nkansa | Physical Medicine & Rehabilitation | 2585 East Washington Blvd, Pasadena, CA 91107 | 2020-06-23 |
| 1609402742 | H & S Hospice Care Inc | Hospice Care, Community Based | 2525 E Colordo Blvd Suite 109, Pasadena, CA 91107 | 2020-03-20 |
| 1013557115 | Cindy Phun | Pharmacist | 3383 E Foothill Blvd, Pasadena, CA 91107 | 2020-01-07 |
| 1184185548 | Preferred Home Health Services | Home Health | 40 N Atlandena Dr Suite 219, Pasadena, CA 91107 | 2019-03-28 |
| 1861973729 | Julia E Underwood | Doula | 2335-115 E. Colorado Blvd #339, Pasadena, CA 91107 | 2018-08-28 |
| 1982183166 | Melissa Castillo | Counselor | 26 S Kinneloa Ave, Pasadena, CA 91107 | 2018-08-09 |
| 1083109904 | Lourice Boutros | Optometrist | 3235 E Colorado Blvd Ste 101, Pasadena, CA 91107 | 2018-06-22 |
| 1902313026 | Cecily Brogdon | Marriage & Family Therapist | 2115 Lambert Drive, Pasadena, CA 91107 | 2018-01-10 |
| 1790204915 | Vanessa Nicole Contreras | Licensed Vocational Nurse | 36 S. Kinneiloa Ave., Pasadena, CA 91107 | 2017-09-19 |
| 1730614397 | Rita Mason | Behavioral Analyst | 890 S Rosemead Blvd, Ste 45, Pasadena, CA 91107 | 2017-04-20 |
| Find all providers in zip 91107 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417119413 | Barbara Beboua | Licensed Psychiatric Technician | 1627 N Oxford Ave, Pasadena, CA 91104 | 2008-06-30 |
| 1487262846 | Sharon Marie Sullivan | Licensed Psychiatric Technician | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-07-21 |
| 1568093706 | Amanda Kathleen Pearson | Licensed Psychiatric Technician | 1020 S Arroyo Pkwy, Pasadena, CA 91105-3911 | 2020-01-27 |
| 1023652898 | Taylor Nicole Hannon | Licensed Psychiatric Technician | 1020 S Arroyo Pkwy, Pasadena, CA 91105-3911 | 2019-11-04 |
| 1184266793 | Esther Hicks | Licensed Psychiatric Technician | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2019-10-15 |
| 1598312605 | Alena Luna | Licensed Psychiatric Technician | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2019-08-22 |
| 1164078564 | Ginger Anne Brooks | Licensed Psychiatric Technician | 1450 N Lake Ave Ste 150, Pasadena, CA 91104-2388 | 2019-08-13 |
| 1083269252 | Sean Jaret Luat | Licensed Psychiatric Technician | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2019-08-05 |
| 1396390720 | Lauren Smith | Licensed Psychiatric Technician | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2019-08-02 |
| 1184187957 | Emerson Sousa | Licensed Psychiatric Technician | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2019-04-09 |
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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.