Provider Demographics
NPI:1447032834
Name:MEDINA, CLAUDIA R (LMFT)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:R
Last Name:MEDINA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W ALTON AVE APT A
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-4072
Mailing Address - Country:US
Mailing Address - Phone:714-227-3948
Mailing Address - Fax:
Practice Address - Street 1:421 W ALTON AVE APT A
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-4072
Practice Address - Country:US
Practice Address - Phone:714-227-3948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139363106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist