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NPI Code Detail

MEDICARE: MELISSA MCMANIS LCSW

MEDICARE: MELISSA MCMANIS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker156651CA
21041C0700XClinical Social Worker26605CA

General Provider Information

NPI Number : 1063574895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MCMANIS LCSW
Provider Business Mailing Address
First Line : 26861 VIA SAN JOSE
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-1812
Country : US
Telephone Number : 562-656-0788
Fax Number :
Provider Business Practice Location Address
First Line : 19712 MACARTHUR BLVD
Second Line :
City : IRVINE
State : CA
Zip : 92612-2407
Country : US
Telephone Number : 562-656-0788
Fax Number : 916-857-9402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 10/07/2024

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Directions to “ MELISSA MCMANIS LCSW” Practice Location

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