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NPI Code Detail

MEDICARE: DOROTHY NIETO MANZER LCSW

MEDICARE: DOROTHY NIETO MANZER LCSW
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 WorkerLCS15377CA

General Provider Information

NPI Number : 1710823125
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHY NIETO MANZER LCSW
Provider Business Mailing Address
First Line : 18352 CRANBROOK DR
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-2048
Country : US
Telephone Number : 714-325-7045
Fax Number :
Provider Business Practice Location Address
First Line : 669 W 34TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90089-0067
Country : US
Telephone Number : 714-325-7045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2026
Last Update Date : 04/27/2026

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