Andrea Rosemary Medina

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF 67037 Issued in CA

Practice address

714 W Main St
Grass Valley, CA 95945-6410

Phone

(530) 477-9800

NPI assigned

Feb 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1710227004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 266",
            "city": "ELMIRA",
            "state": "CA",
            "postal_code": "956250266",
            "telephone_number": "707-365-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W MAIN ST",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959456410",
            "telephone_number": "530-477-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2012 Hamstead Ct",
            "address_purpose": "LOCATION",
            "city": "Vacaville",
            "state": "CA",
            "postal_code": "956877790",
            "country_code": "US",
            "telephone_number": "707-365-2847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ANDREA",
        "middle_name": "ROSEMARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-22",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 67037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MD Partners Ipa
• Meadow View Manor, Inc.
• Teresa M Meadow
• Megan Meadows
• Sarah Meadows
• Maria Ahleen De Leon Medina, DMD
• Robert Meier, RPH
• Cara W Meinholz, M.D.
• Arthur Meinung
• Justin Melvin

• Marriage & Family Therapist in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.