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NPI Code Detail

MEDICARE: MRS. MARIBEL MANCILLAS

MEDICARE: MRS. MARIBEL MANCILLAS
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
11041C0700XClinical Social WorkerL65758CA

General Provider Information

NPI Number : 1376667881
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIBEL MANCILLAS
Provider Business Mailing Address
First Line : 26904 LAS MANANITAS DR
Second Line :
City : VALENCIA
State : CA
Zip : 91354-2201
Country : US
Telephone Number : 818-941-5090
Fax Number :
Provider Business Practice Location Address
First Line : 427 ENCINAL CANYON RD
Second Line :
City : MALIBU
State : CA
Zip : 90265-2404
Country : US
Telephone Number : 213-369-4866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 04/28/2025

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Directions to “ MRS. MARIBEL MANCILLAS ” Practice Location

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