Provider Demographics
NPI:1942810247
Name:MANALO, PRECIOUS ALLANE LAXAMANA
Entity Type:Individual
Prefix:
First Name:PRECIOUS ALLANE
Middle Name:LAXAMANA
Last Name:MANALO
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 1:1661 VIA LACQUA
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:CA
Mailing Address - Zip Code:94580-2026
Mailing Address - Country:US
Mailing Address - Phone:510-508-6109
Mailing Address - Fax:
Practice Address - Street 1:1151 A ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4113
Practice Address - Country:US
Practice Address - Phone:510-999-9055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst