EDGAR IVAN MANZANO

SAN RAFAEL, CA
NPI1730952573
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TA0400X Psychologist, Addiction (Substance Use Disorder)
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2023-11-02
Last Update Date2023-11-06
Business Address
EDGAR IVAN MANZANO
1601 2ND ST
SAN RAFAEL, CA 94901-2712
Phone number: 415-456-6655
Mailing Address
EDGAR IVAN MANZANO
1601 2ND ST
SAN RAFAEL, CA 94901-2712
Phone number: 415-456-6655