Provider Demographics
NPI:1396635850
Name:MANRIQUEZ, ANDREW RUBIO
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:RUBIO
Last Name:MANRIQUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 TAMPA AVE SPC 565
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-2503
Mailing Address - Country:US
Mailing Address - Phone:818-257-3950
Mailing Address - Fax:818-279-0658
Practice Address - Street 1:9301 TAMPA AVE SPC 565
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-2503
Practice Address - Country:US
Practice Address - Phone:818-257-3950
Practice Address - Fax:818-279-0658
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist