Provider Demographics
NPI:1164554770
Name:PATEL, MANISHA (MA LMFT)
Entity Type:Individual
Prefix:MS
First Name:MANISHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 STILL MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-1782
Mailing Address - Country:US
Mailing Address - Phone:661-917-2162
Mailing Address - Fax:
Practice Address - Street 1:6121 STILL MEADOW LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-1782
Practice Address - Country:US
Practice Address - Phone:661-917-2162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81058106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist