Kimberly Samantha Medina, is a
Social Worker - Clinical based in Los Angeles, California. Kimberly Samantha Medina is licensed to practice in California (license number ASW90543) and her current practice location is
1200 Wilshire Blvd Ste 300, Los Angeles, California. She can be reached at her office (for appointments etc.) via phone at
(213) 481-7464.
NPI number for Kimberly Samantha Medina is 1063994788 and her current mailing address is 1200 Wilshire Blvd Ste 300, Los Angeles, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1063994788.
Healthcare Provider's Profile
Full Name | Kimberly Samantha Medina |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 1200 Wilshire Blvd Ste 300, Los Angeles, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1063994788
- Provider Enumeration Date: 08/29/2018
- Last Update Date: 10/24/2023
Medical Identifiers
Medical identifiers for Kimberly Samantha Medina such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063994788 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | ASW90543 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Samantha Medina is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kimberly Samantha Medina, 1200 Wilshire Blvd Ste 300, Los Angeles, CA 90017-1931 Ph: (213) 481-7464 | Kimberly Samantha Medina, 1200 Wilshire Blvd Ste 300, Los Angeles, CA 90017-1931 Ph: (213) 481-7464 |
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