Provider Demographics
NPI:1508611435
Name:MANN, RIPONJIT
Entity Type:Individual
Prefix:MR
First Name:RIPONJIT
Middle Name:
Last Name:MANN
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 1:555 RALPH APPEZZATTO MEMORIAL PARKWAY
Mailing Address - Street 2:PORTABLE #1
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501
Mailing Address - Country:US
Mailing Address - Phone:510-748-4021
Mailing Address - Fax:
Practice Address - Street 1:555 RALPH APPEZZATTO MEMORIAL PARKWAY
Practice Address - Street 2:PORTABLE #1
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501
Practice Address - Country:US
Practice Address - Phone:510-748-4021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190171055101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool