Provider Demographics
NPI:1629140900
Name:MANNING, CATHERINE ANNE (ASW)
Entity Type:Individual
Prefix:MISS
First Name:CATHERINE
Middle Name:ANNE
Last Name:MANNING
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93483-0018
Mailing Address - Country:US
Mailing Address - Phone:805-928-1707
Mailing Address - Fax:805-922-4797
Practice Address - Street 1:105 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-4319
Practice Address - Country:US
Practice Address - Phone:805-928-1707
Practice Address - Fax:805-922-4797
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW9387104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker