Healthcare Provider Details

I. General information

NPI: 1649134024
Provider Name (Legal Business Name): CIARA VALERIE ROSE MANNING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

953 DAVIS ST
VACAVILLE CA
95687-5422
US

IV. Provider business mailing address

953 DAVIS ST
VACAVILLE CA
95687-5422
US

V. Phone/Fax

Practice location:
  • Phone: 707-392-7308
  • Fax:
Mailing address:
  • Phone: 707-392-7308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberY9283170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: