Provider Demographics
NPI:1356110555
Name:MANALAD, JOSELITO
Entity type:Individual
Prefix:MR
First Name:JOSELITO
Middle Name:
Last Name:MANALAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6091 GLENHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-6030
Mailing Address - Country:US
Mailing Address - Phone:951-252-7397
Mailing Address - Fax:
Practice Address - Street 1:13100 STUDEBAKER RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2500
Practice Address - Country:US
Practice Address - Phone:562-868-3751
Practice Address - Fax:562-929-2234
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA763933163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health