Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Dyane Burgos Medina, LCSW

Individual provider Clinical Social Worker · NPI 1396569596

MS. Dyane Burgos Medina, LCSW is a Clinical Social Worker in Elk Grove, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2024
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

10053 E Taron Dr
Elk Grove, CA 95757-8161
Phone: (209) 403-6722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 112033 (CA)

Record details

NPI number1396569596
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedNovember 13, 2024
Last updated in NPPESNovember 13, 2024
Certification dateNovember 13, 2024

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