Provider Demographics
NPI:1922998533
Name:MEDEL, KERRI B (MFT)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:B
Last Name:MEDEL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17750 GOLDEN MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:96022-9647
Mailing Address - Country:US
Mailing Address - Phone:530-227-6466
Mailing Address - Fax:
Practice Address - Street 1:2110 FERRY ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-3459
Practice Address - Country:US
Practice Address - Phone:530-394-3054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health