Provider Demographics
NPI:1730662255
Name:LOMELI, MANUEL (MHA-III)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:LOMELI
Suffix:
Gender:M
Credentials:MHA-III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5417 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-3164
Mailing Address - Country:US
Mailing Address - Phone:916-388-3231
Mailing Address - Fax:916-388-3232
Practice Address - Street 1:5417 MADISON AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-3164
Practice Address - Country:US
Practice Address - Phone:916-388-3231
Practice Address - Fax:916-388-3232
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator