| Doctor Name: | MR. ADOLFO JORGE MEDINA |
| NPI Number: | 1033123849 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMFT |
| License Number: | MFC35047 |
| Business Practice Address: | 5978 Greenwood Cmn Livermore, CA - 945504798 |
| Business Phone Number: | 9255189168 |
| Business Fax Number: | 9253736654 |
| Mailing Address: | 5978 Greenwood Cmn, LIVERMORE |
| State: | CA |
| Postal Code: | 945504798 |
| Phone Number: | 9253736654 |
| Fax Number: | 9253736654 |
| NPI Enumeration Date: | 07/28/2006 |
| NPI Last Update Date: | 08/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MFC35047 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |