Healthcare Provider Details

I. General information

NPI: 1407905888
Provider Name (Legal Business Name): KRISTEN MANNING FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

587 RIO LINDO AVE
CHICO CA
95926-1816
US

IV. Provider business mailing address

2644 LAKEWEST DR
CHICO CA
95928-3813
US

V. Phone/Fax

Practice location:
  • Phone: 530-345-1306
  • Fax:
Mailing address:
  • Phone: 510-673-7251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95030506
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: