CAROLYN S. MANSON (NPI# 1205900529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205900529 |
| Entity Type | Individual |
| Full Name | CAROLYN S. MANSON |
| Credential | MD |
| Practice Address |
3400 Delta Fair Blvd Antioch CA 94509-4004 |
| Mailing Address |
1800 Harrison St Fl 7 Oakland CA 94612-3429 |
| Practice Telephone | 9257795000 |
| Mailing Telephone | 5106256262 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
G52535 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G525350 | 05 |
| Street Address |
3400 DELTA FAIR BLVD |
| City | ANTIOCH |
| State | CA |
| Zip Code | 94509-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215929914 | Barbara A Rhoades | Nurse Practitioner | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2005-08-18 |
| 1962936849 | Nardip Singh | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-17 |
| 1649704743 | Anh X Nguyen | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-14 |
| 1104359918 | Borey Som | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-07 |
| 1790005015 | Elizabeth Seidler | Dermatology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2010-06-09 |
| 1699091793 | Allison Townsend Hampton | Pediatrics | 3400 Delta Fair Blvd, Department of Pediatrics, Antioch, CA 94509-4004 | 2010-04-14 |
| 1063746998 | Athena Panzar | Counselor | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2009-09-24 |
| 1083859888 | Philip Song | Dermatology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2008-12-08 |
| 1033319215 | Sanaz Stacy Aboutalebi-simon | Optometrist | 3400 Delta Fair Blvd, The Permanente Medical Group, Inc., Antioch, CA 94509-4004 | 2007-07-24 |
| 1700099264 | Derek S Mongold | Family Medicine | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2007-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733243 | A Step Above, LLC | Clinic/Center | 3648 Delta Fair Blvd., Antioch, CA 94509 | 2020-02-25 |
| 1134751167 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 3600 Delta Fair Blvd, Antioch, CA 94509 | 2020-02-07 |
| 1962040865 | Melay Goitom | Behavioral Analyst | 3104 Delta Fair Boulevard, Antioch, CA 94509 | 2019-12-11 |
| 1518525062 | James Joseph Cook | Counselor | 624 W. 14th Street B, Antioch, CA 94509 | 2019-05-30 |
| 1922576438 | Wazma Matiee | Behavioral Analyst | 2009 Asilomar Dr., Antioch, CA 94509 | 2018-11-02 |
| 1346722360 | Dharma Rachelle Yancy | Behavioral Analyst | 3401 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1912489931 | Cristian Cruz | Behavioral Analyst | 3100-3104 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1780174052 | Melissa Sue Rossi | Counselor | 3701 Lone Tree Way Ste 7a, Antioch, CA 94509 | 2018-05-13 |
| 1033638085 | Elizabeth Marie Artola | Counselor | 1915 D Street, Antioch, CA 94509 | 2017-09-11 |
| 1144748690 | Andrea Michelle Newberry | Counselor | 55 E.18th St, Antioch, CA 94509 | 2017-09-05 |
| Find all providers in zip 94509 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982778593 | Debra J. Denherder | Psychiatry & Neurology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710506308 | Nisha Warikoo Md Inc | Psychiatry & Neurology | 19200 Von Karman Ave, Ste 623, Irvine, CA 92612-8553 | 2020-04-13 |
| 1043848872 | Nelson Md and Lochhead Md, A Professional Medical Corporation | Psychiatry & Neurology | 28202 Cabot Rd Ste 635, Laguna Niguel, CA 92677-1222 | 2020-03-28 |
| 1003455460 | Ranvinder Kaur Rai Md | Psychiatry & Neurology | 39676 Mission Blvd, Fremont, CA 94539-3000 | 2020-01-03 |
| 1043856073 | Ocean View Neuropsychiatry | Psychiatry & Neurology | 31862 Coast Highway Unit 302, Laguna Beach, CA 92651 | 2019-11-25 |
| 1275190068 | Allan S Abrams Md Inc | Psychiatry & Neurology | 4726 Winnetka Ave, Woodland Hills, CA 91364-4737 | 2019-05-28 |
| 1225527427 | Better Life Therapy, Inc. | Psychiatry & Neurology | 9520 Escondido Canyon Rd, Santa Clarita, CA 91390-4811 | 2018-05-03 |
| 1821515099 | J. Kirk Hartman, M.d. | Psychiatry & Neurology | 3860 Blackhawk Rd # 120, Danville, CA 94506-4905 | 2017-08-28 |
| 1912432055 | Centered Health LLC | Psychiatry & Neurology | 6422 W 6th St, Los Angeles, CA 90048-4714 | 2017-04-26 |
| 1255871182 | Carol R Harrus | Psychiatry & Neurology | 517 Patricia Ln, Palo Alto, CA 94303-2856 | 2017-02-25 |
| 1437539509 | Ehab Yacoub, Md Inc. | Psychiatry & Neurology | 1225 W 190th St Ste 470, Gardena, CA 90248-4316 | 2015-06-04 |
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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.