Provider Demographics
NPI:1942527338
Name:MCMANUS, JEREMI ROSS (MA)
Entity Type:Individual
Prefix:
First Name:JEREMI
Middle Name:ROSS
Last Name:MCMANUS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1724
Mailing Address - Country:US
Mailing Address - Phone:415-683-8510
Mailing Address - Fax:
Practice Address - Street 1:668 QUINAN ST
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-1621
Practice Address - Country:US
Practice Address - Phone:510-741-7286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist