Provider Demographics
NPI:1912872649
Name:MANGANARO, JAMES (AMFT 147017)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MANGANARO
Suffix:
Gender:M
Credentials:AMFT 147017
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2626
Mailing Address - Country:US
Mailing Address - Phone:628-271-7326
Mailing Address - Fax:
Practice Address - Street 1:1360 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2626
Practice Address - Country:US
Practice Address - Phone:628-271-7326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147017106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist