Active NPI
Arcenia Medina
- Specialist
- Palmdale, CA
National Provider Identifier
1750152815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 175T00000X
- Practice address
- 1605 Sussex CT
Palmdale, CA 93550-6998 - Phone
- (661) 726-2630
- NPI assigned
- Jan 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 175T00000X | CA | Primary |
Addresses
Primary practice location
1605 Sussex CT
Palmdale, CA 93550-6998
Mailing address
44447 10TH St West
Lancaster, CA 93534
Phone (661) 726-2630
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 175T00000X | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704758400000",
"number": "1750152815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44447 10TH ST WEST",
"city": "LANCASTER",
"state": "CA",
"postal_code": "93534",
"telephone_number": "661-726-2630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 SUSSEX CT",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935506998",
"telephone_number": "661-726-2630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "ARCENIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-09",
"last_updated": "2024-01-09",
"certification_date": "2024-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "175T00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.