Diandra Crystal Medina, LMFT
Marriage & Family Therapist in San Diego, CA. Individual provider (NPI-1).
NPI number1265713309
StatusActive
Last updated in NPPESOct 3, 2018
Details
- NPI
- 1265713309
- Entity type
- Individual (NPI-1)
- Name
- Diandra Crystal Medina
- Credential
- LMFT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 2, 2011
- Last updated
- Oct 3, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 96724 | CA | Yes |
| 106H00000X | Marriage & Family Therapist | 78053 | – |
Practice location
1450 University Ave # 101San Diego, CA 92103-3405
Phone 619-365-9958
Mailing address
4303 Avalon DrSan Diego, CA 92103-1307
Other practice locations
1870 Cordell Ct Ste 101
El Cajon, CA 92020-0915
El Cajon, CA 92020-0915
Phone 619-448-9700
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