Healthcare Provider Details

I. General information

NPI: 1528930104
Provider Name (Legal Business Name): CHRISTINE MANESE PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALD LN
FALLBROOK CA
92028-3029
US

IV. Provider business mailing address

300 HEALD LN
FALLBROOK CA
92028-3029
US

V. Phone/Fax

Practice location:
  • Phone: 760-695-9694
  • Fax:
Mailing address:
  • Phone: 760-695-9694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number230058033
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: