Healthcare Provider Details

I. General information

NPI: 1982533063
Provider Name (Legal Business Name): MANUELA SINISTERRA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

415 L ST NW APT 1346
WASHINGTON DC
20001-2956
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-6364
  • Fax:
Mailing address:
  • Phone: 305-484-5709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number07478
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: