Provider Demographics
NPI:1326226887
Name:SATAYAPRASERT, MANANYA (MD)
Entity Type:Individual
Prefix:
First Name:MANANYA
Middle Name:
Last Name:SATAYAPRASERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 W PUEBLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4365
Mailing Address - Country:US
Mailing Address - Phone:805-898-3240
Mailing Address - Fax:805-898-3249
Practice Address - Street 1:317 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105
Practice Address - Country:US
Practice Address - Phone:805-898-3240
Practice Address - Fax:805-898-3249
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52880-20207R00000X
ORMD154897207R00000X
MDP22029207R00000X
WI528802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine