Healthcare Provider Details

I. General information

NPI: 1225995343
Provider Name (Legal Business Name): MR. MANUEL MANCERA JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 S KNOTT AVE
ANAHEIM CA
92804-4711
US

IV. Provider business mailing address

7641 13TH ST APT A
WESTMINSTER CA
92683-4370
US

V. Phone/Fax

Practice location:
  • Phone: 714-236-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: