1922174598 NPI number — MS. PAT ANNE MANN M.A.

Table of content: (NPI 1972393510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922174598 NPI number — MS. PAT ANNE MANN M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MANN
Provider First Name:
PAT
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MANN
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
A.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A..
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1922174598
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 POST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LADERA RANCH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92694-0413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-388-7335
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31882 CAMINO CAPISTRANO
Provider Second Line Business Practice Location Address:
#108
Provider Business Practice Location Address City Name:
SAN JUAN CAPISTRANO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92675-3222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-330-1642
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)