Search › California › 1041C0700X
Marisa Medina, LCSW127143
NPI 1770757445 · on the registry since 2008 · sole proprietor
Practice
- Address
- 17343 Anastasia Ave
Fontana, CA 92335 - Phone
- (626) 201-6674
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YA0400X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-01-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California