Provider Demographics
NPI:1780898668
Name:MANAVI, JENNIFFER ANN (MA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFFER
Middle Name:ANN
Last Name:MANAVI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 IRVINE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-5119
Mailing Address - Country:US
Mailing Address - Phone:949-574-1645
Mailing Address - Fax:
Practice Address - Street 1:3030 N HESPERIAN ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-1151
Practice Address - Country:US
Practice Address - Phone:714-836-2700
Practice Address - Fax:714-836-2701
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist