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General NPI Number Information
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NPI Number | 1962327296
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Entity Type | Individual
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Provider Name | CARLA MANJARREZ MA
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Gender | Female
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 401 NOGALES ST
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City | LA PUENTE
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State | CA
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Zip | 91744-6144
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Country | US
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Telephone | 626-965-3437
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Fax |
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Provider Business Mailing Address
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Address Line | 5529 BELLA WAY
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City | FONTANA
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State | CA
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Zip | 92336-5954
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Country | US
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Telephone | 626-589-8195
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 250095831
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License Number State | CA
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