Jesse Medel
Day Training/Habilitation Specialist in Los Angeles, CA. Individual provider (NPI-1).
NPI number1215744164
StatusActive
Last updated in NPPESApr 16, 2026
Details
- NPI
- 1215744164
- Entity type
- Individual (NPI-1)
- Name
- Jesse Medel
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 13, 2024
- Certification date
- Apr 16, 2026
- Last updated
- Apr 16, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | – | Yes |
| 172V00000X | Community Health Worker | – | – | |
| 175T00000X | Peer Specialist | MPSS-OTMQFG | CA |
Practice location
655 Maple AveLos Angeles, CA 90014-2211
Phone 310-848-9194
Mailing address
2381 Yosemite DrLos Angeles, CA 90041-2611
Phone 213-713-8781
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