Healthcare Provider Details

I. General information

NPI: 1063323590
Provider Name (Legal Business Name): ANNA ELIZABETH MANFREDA DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W VALLEY PKWY STE 100
ESCONDIDO CA
92025-2557
US

IV. Provider business mailing address

800 W VALLEY PKWY STE 100
ESCONDIDO CA
92025-2557
US

V. Phone/Fax

Practice location:
  • Phone: 800-797-2050
  • Fax:
Mailing address:
  • Phone: 800-797-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95040589
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: