Individual provider Active NPI

Cynthia Yolanda Medina

  • Certified Registered Nurse Anesthetist
  • Ceres, CA
National Provider Identifier
1194591248
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
152813 Issued in CA
Practice address
1708 Louisville CT
Ceres, CA 95307-1860
Phone
(209) 707-6996
NPI assigned
Nov 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95167674 CA
Certified Registered Nurse Anesthetist 367500000X 152813 CA Primary

Addresses

Primary practice location

1708 Louisville CT
Ceres, CA 95307-1860

Mailing address

1708 Louisville CT
Ceres, CA 95307-1860
Phone (209) 707-6996

Other practice location 1

20 E River Park Pl W
Fresno, CA 93720-1551
Phone (559) 256-4950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250314001193 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608398003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Regional Anesthesia Associates IncGroup PAC ID 3870964323, 143 clinicians

Practice addresses (Care Compare)

1420 E Roseville Pkwy
Suite 100
Roseville, CA 95661-3080
Phone (916) 677-2488

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
152813CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Regional Anesthesia Associates Inc CurrentSince Jan 3, 2025 Accepting new patients

Locations

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

1420 E Roseville Pkwy
Ste 100
Roseville, CA 95661
Phone (916) 677-2488

2800 Benedict Dr
San Leandro, CA 94577
Phone (510) 357-8300

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1194591248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 LOUISVILLE CT",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953071860",
            "telephone_number": "209-707-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 LOUISVILLE CT",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953071860",
            "telephone_number": "209-707-6996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 E River Park Pl W",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937201551",
            "country_code": "US",
            "telephone_number": "559-256-4950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "CYNTHIA",
        "middle_name": "YOLANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95167674",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "152813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ceres, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.