Individual provider · Type 1 NPI

Stacey Ann Medina

Counselor · Modesto, CA

NPI number 1699637751 Active

Practice location

1000 Coffee Rd
Modesto, CA 95355-4204

Call (209) 492-2470 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1699637751

Stacey Ann Medina's National Provider Identifier is 1699637751, issued on Nov 26, 2025. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Modesto, CA. The record was last updated on Jan 23, 2026.