Provider Demographics
NPI:1164600631
Name:MANHEIM, THOMAS C (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:MANHEIM
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 HIGHLAND DR
Mailing Address - Street 2:212-C
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2408
Mailing Address - Country:US
Mailing Address - Phone:858-729-1133
Mailing Address - Fax:
Practice Address - Street 1:990 HIGHLAND DR
Practice Address - Street 2:212-C
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2408
Practice Address - Country:US
Practice Address - Phone:858-729-1133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38369106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist