ANTOINETTE MANGUM (NPI# 1124543293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124543293 |
| Entity Type | Individual |
| Full Name | ANTOINETTE MANGUM |
| Practice Address |
15305 Rayen St North Hills CA 91343-5117 |
| Practice Telephone | 8188923423 |
| Mailing Telephone | 8188923423 |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2017-09-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | 95-2633765 | 01 |
| Street Address |
15305 RAYEN ST |
| City | NORTH HILLS |
| State | CA |
| Zip Code | 91343-5117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881793313 | Penny Lane Centers | Case Management | 15305 Rayen St, North Hills, CA 91343-5117 | 2006-09-21 |
| 1669099289 | Jakuta M Ptah | Marriage & Family Therapist | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-06-30 |
| 1609404128 | Kimberly Jimenez | Rehabilitation Practitioner | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-03-30 |
| 1134754179 | Leanna Alexis Ramos | Case Manager/Care Coordinator | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-03-10 |
| 1295369288 | Edwin Javier Olmedo | Case Manager/Care Coordinator | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-02-27 |
| 1457985442 | Cristal Torres | Rehabilitation Practitioner | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-02-27 |
| 1295369411 | Emanuel Huerta Serna | Case Manager/Care Coordinator | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-02-26 |
| 1558991539 | Eduardo Garcia | Case Manager/Care Coordinator | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-01-19 |
| 1568002020 | Jaspreet Singh | Counselor | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-01-13 |
| 1720627433 | Jennifer Tobon | Case Manager/Care Coordinator | 15305 Rayen St, North Hills, CA 91343-5117 | 2019-12-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487261681 | Esperanza Armenta | Case Manager/Care Coordinator | 16861 Parthenia Street, North Hills, CA 91343 | 2020-09-30 |
| 1295355758 | Island One and Associates | Social Worker | 9528 Lemona Ave, North Hills, CA 91343 | 2020-04-24 |
| 1154951416 | Estefanie Ramos | Case Manager/Care Coordinator | 16861 Parthenia St., North Hills, CA 91343 | 2020-01-24 |
| 1336793728 | Mitra Minovi | Dentist | 9444 Ruffner Ave, Northridge, CA 91343 | 2019-07-24 |
| 1649762600 | Reza Akbar, Dds, Inc. | Dentist | 15300 Parthenia St, North Hills, CA 91343 | 2018-06-05 |
| 1073002663 | Golmah Zarinkhou | Student in an Organized Health Care Education/Training Program | Va Sepulveda Ambulatory Care Center, 16111 Plummer, Street Dental Services (160), Bldg 10 Rm 1c-100, North Hills, CA 91343 | 2018-05-09 |
| 1740729037 | Ophelia Sanchez | Case Manager/Care Coordinator | 15305 Rayen, North Hills, CA 91343 | 2017-02-20 |
| 1386001519 | Ada Angeles | Dietitian, Registered | 15210 Parthenia, North Hills, CA 91343 | 2016-01-19 |
| 1043691371 | Valley Grace Home, Inc. | Skilled Nursing Facility | 16052 Chase St, North Hills, CA 91343 | 2015-06-11 |
| 1063828234 | Joshua Tree Healthcare, Inc. | Home Health | 16909 Parthenia St Ste 302a, Northridge, CA 91343 | 2014-07-08 |
| Find all providers in zip 91343 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487261681 | Esperanza Armenta | Case Manager/Care Coordinator | 16861 Parthenia Street, North Hills, CA 91343 | 2020-09-30 |
| 1154951416 | Estefanie Ramos | Case Manager/Care Coordinator | 16861 Parthenia St., North Hills, CA 91343 | 2020-01-24 |
| 1740729037 | Ophelia Sanchez | Case Manager/Care Coordinator | 15305 Rayen, North Hills, CA 91343 | 2017-02-20 |
| 1730549155 | Jasmine Cadena | Case Manager/Care Coordinator | 8758 Aqueduct Ave, North Hills, CA 91343-4904 | 2016-02-26 |
| 1881973097 | Maria O Munoz-dias | Case Manager/Care Coordinator | 15305 Rayen Street, North Hills, CA 91343 | 2011-08-05 |
| 1114231495 | Yesenia Hernandez | Case Manager/Care Coordinator | 15317 Rayen St., North Hills, CA 91343 | 2010-07-29 |
| 1457482127 | Martha P Medina | Case Manager/Care Coordinator | 15302 Rayen St, North Hills, CA 91343-5118 | 2007-03-07 |
| 1134754179 | Leanna Alexis Ramos | Case Manager/Care Coordinator | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-03-10 |
| 1295369288 | Edwin Javier Olmedo | Case Manager/Care Coordinator | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-02-27 |
| 1295369411 | Emanuel Huerta Serna | Case Manager/Care Coordinator | 15305 Rayen St, North Hills, CA 91343-5117 | 2020-02-26 |
| Find all providers in NORTH HILLS | ||||
| City | NORTH HILLS |
| Zip Code | 91343 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.