Provider Demographics
NPI:1588121388
Name:MEDINA, HELEEN GUADALUPE (BA)
Entity type:Individual
Prefix:
First Name:HELEEN
Middle Name:GUADALUPE
Last Name:MEDINA
Suffix:
Gender:
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11541 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3898
Mailing Address - Country:US
Mailing Address - Phone:562-923-9414
Mailing Address - Fax:562-923-9551
Practice Address - Street 1:11541 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3898
Practice Address - Country:US
Practice Address - Phone:562-923-9414
Practice Address - Fax:562-923-9414
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician