Provider Demographics
NPI:1710256482
Name:MCMANUS, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8376 HERCULES ST
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942
Mailing Address - Country:US
Mailing Address - Phone:619-667-6891
Mailing Address - Fax:619-469-7279
Practice Address - Street 1:8376 HERCULES ST
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2902
Practice Address - Country:US
Practice Address - Phone:619-667-6891
Practice Address - Fax:619-469-7279
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator