MEDICARE: SYDNEY RECHELLE MANNING

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1316750342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY RECHELLE MANNING

Provider Business Mailing Address
First Line	:	2910 COLOMA ST
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-4408
Country	:	US
Telephone Number	:	435-823-1327
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 SAINT ANDREWS DR
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-4248
Country	:	US
Telephone Number	:	916-337-9842
Fax Number	:

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

Provider Enumeration Date	:	01/31/2025
Last Update Date	:	01/31/2025

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1770841512 — DR. BENJAMIN L FOULK DDS
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Practice Location Address:

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Directions to “ SYDNEY RECHELLE MANNING ” Practice Location

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