Provider Demographics
NPI:1922174598
Name:MANN, PAT ANNE (MA)
Entity Type:Individual
Prefix:MS
First Name:PAT
Middle Name:ANNE
Last Name:MANN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:2 POST ST
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-0413
Mailing Address - Country:US
Mailing Address - Phone:949-388-7335
Mailing Address - Fax:
Practice Address - Street 1:31882 CAMINO CAPISTRANO
Practice Address - Street 2:#108
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3222
Practice Address - Country:US
Practice Address - Phone:949-330-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health