Healthcare Provider Details

I. General information

NPI: 1558948208
Provider Name (Legal Business Name): MANASI SONI PARRISH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BAUCHET ST
LOS ANGELES CA
90012-2907
US

IV. Provider business mailing address

PO BOX 24449
NEW YORK NY
10087-0589
US

V. Phone/Fax

Practice location:
  • Phone: 818-452-2978
  • Fax:
Mailing address:
  • Phone: 833-351-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME164774
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number3176151
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number209172
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number103529
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: