Audrey Moreno Medina, is a
Student In An Organized Health Care Education/training Program based in Culver City, California. Audrey Moreno Medina is licensed to practice in * (Not Available) (license number ) and her current practice location is
4760 Sepulveda Blvd, Culver City, California. She can be reached at her office (for appointments etc.) via phone at
(310) 390-6612.
NPI number for Audrey Moreno Medina is 1710613161 and her current mailing address is 556 S Fair Oaks Ave Ste 101, Pasadena, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1710613161.
Healthcare Provider's Profile
| Full Name | Audrey Moreno Medina |
|---|
| Gender | Female |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 4760 Sepulveda Blvd, Culver City, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1710613161
- Provider Enumeration Date: 07/28/2022
- Last Update Date: 05/07/2024
Medical Identifiers
Medical identifiers for Audrey Moreno Medina such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710613161 | NPI | - | NPPES |
| 1952562910 | Other | CA | PSYCHOTHERAPY |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 106H00000X | Marriage & Family Therapist | 141738 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Audrey Moreno 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 |
|---|
Audrey Moreno Medina,
556 S Fair Oaks Ave Ste 101,
Pasadena, CA 91105-2657
Ph: (626) 788-2831 | Audrey Moreno Medina,
4760 Sepulveda Blvd,
Culver City, CA 90230-4820
Ph: (310) 390-6612 |
Reviews and Comments