Daniel Ricardo Medina

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

7171 Bowling Dr Ste 300
Sacramento, CA 95823-2043

Phone

(916) 394-9195

Fax

(916) 392-2827

NPI assigned

Sep 8, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1811204159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 WILLIAMSBOURGH DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232006",
            "telephone_number": "916-395-3552",
            "fax_number": "916-473-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 BOWLING DR STE 300",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232043",
            "telephone_number": "916-394-9195",
            "fax_number": "916-392-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "DANIEL",
        "middle_name": "RICARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-08",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Medina Hernandez
• Carlos Alonso Medina Mendez, M.D.
• Carla Medina, NP
• Chandra Medina
• Danette Medina
• Erica Medina, M.A. LMFT
• Frank A Medina
• Graciela P, Medina
• Gustavo Medina
• Jennifer Medina

• Peer Specialist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.