Provider Demographics
NPI:1760895577
Name:MANIO (STEDMAN IS MAIDEN), JESSINA MARIE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JESSINA
Middle Name:MARIE
Last Name:MANIO (STEDMAN IS MAIDEN)
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:JESSINA
Other - Middle Name:
Other - Last Name:STEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1530 CONCORDIA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-3203
Mailing Address - Country:US
Mailing Address - Phone:949-214-3246
Mailing Address - Fax:949-214-3246
Practice Address - Street 1:1530 CONCORDIA
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-3203
Practice Address - Country:US
Practice Address - Phone:949-214-3246
Practice Address - Fax:949-214-3246
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer