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General NPI Number Information
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NPI Number | 1437387784
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Entity Type | Individual
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Provider Name | KRISTIN LOUISE MANUEL LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 2801 K ST STE 240
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City | SACRAMENTO
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State | CA
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Zip | 95816-5170
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Country | US
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Telephone | 916-887-4660
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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Country | US
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Telephone | 916-708-8083
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 53052
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW60824
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License Number State | CA
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