Provider Demographics
NPI:1467207845
Name:CERVANTES-MANZO PSYCHOLOGICAL SERVICES, PC
Entity Type:Organization
Organization Name:CERVANTES-MANZO PSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/BILINGUAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YURIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CERVANTES-MANZO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-765-1894
Mailing Address - Street 1:530 S LAKE AVE # 595
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:530 S LAKE AVE # 595
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-3515
Practice Address - Country:US
Practice Address - Phone:626-765-1894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health