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General NPI Number Information
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NPI Number | 1407656416
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Entity Type | Individual
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Provider Name | JOSHUA JAMES MANLEY
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Gender | Male
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 3330 CAMERON PARK DR STE 400
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City | CAMERON PARK
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State | CA
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Zip | 95682-7652
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Country | US
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Telephone | 916-581-0054
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 BLUE RAVINE RD APT 827
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City | FOLSOM
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State | CA
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Zip | 95630-3809
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 152006
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License Number State | CA
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