Marisa Denise Medina, LCSW127143 is a
Social Worker - Clinical based in Fontana, California. Marisa Denise Medina is licensed to practice in California (license number LCSW127143) and her current practice location is
17343 Anastasia Ave, Fontana, California. She can be reached at her office (for appointments etc.) via phone at
(626) 201-6674.
NPI number for Marisa Denise Medina is 1770757445 and her current mailing address is 12813 Philadelphia St, Whittier, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1770757445.
Healthcare Provider's Profile
| Full Name | Marisa Denise Medina |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 17343 Anastasia Ave, Fontana, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1770757445
- Provider Enumeration Date: 04/14/2008
- Last Update Date: 01/16/2025
Medical Identifiers
Medical identifiers for Marisa Denise Medina such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770757445 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW127143 (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. Marisa Denise 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 |
|---|
Marisa Denise Medina, LCSW127143
12813 Philadelphia St,
Whittier, CA 90601-4118
Ph: (562) 693-0400 | Marisa Denise Medina, LCSW127143
17343 Anastasia Ave,
Fontana, CA 92335-4933
Ph: (626) 201-6674 |
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