Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003183948 |
---|---|
Provider Name | Joseph Angelo Maningo |
First Address | Sacramento, CA 95826-3221 |
Second Address | Sacramento, CA 95826-3221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2011 |
Last Update Date | 21/11/2011 |