Provider Demographics
NPI:1689365652
Name:MANALANG, DAVID ROLAND CATAN
Entity Type:Individual
Prefix:MR
First Name:DAVID ROLAND
Middle Name:CATAN
Last Name:MANALANG
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 1:10051 SHANA WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-5956
Mailing Address - Country:US
Mailing Address - Phone:916-513-1316
Mailing Address - Fax:
Practice Address - Street 1:10051 SHANA WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-5956
Practice Address - Country:US
Practice Address - Phone:916-513-1316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician