Provider Demographics
NPI:1003059486
Name:MANNIA, MICHAEL JOSEPH (DMIN)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:MANNIA
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 OFFICE CENTER CT
Mailing Address - Street 2:SUITE #27
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1562
Mailing Address - Country:US
Mailing Address - Phone:661-324-4070
Mailing Address - Fax:
Practice Address - Street 1:5330 OFFICE CENTER CT
Practice Address - Street 2:SUITE #27
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1562
Practice Address - Country:US
Practice Address - Phone:661-324-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral