MEDICARE: MS. CYNTHIA ELIZABETH MANLY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	12331	CA

General Provider Information

NPI Number	:	1043650450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA ELIZABETH MANLY NP

Provider Business Mailing Address
First Line	:	3835 N FREEWAY BLVD STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-1954
Country	:	US
Telephone Number	:	916-576-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2386 FARADAY AVE STE 110
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-7222
Country	:	US
Telephone Number	:	800-930-0803
Fax Number	:	619-383-6701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2013
Last Update Date	:	06/05/2025

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