Individual provider Active NPI

Eriberto Emiliano Manzano, MFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1043234164
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
47609 Issued in CA
Practice address
2719 N Air Fresno Dr
Fresno, CA 93727-1547
Phone
(559) 600-9180
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 47609 CA Primary

Addresses

Primary practice location

2719 N Air Fresno Dr
Fresno, CA 93727-1547

Mailing address

1925 E Dakota Ave
Fresno, CA 93726-4821

Other practice location 1

1925 E Dakota Ave
Fresno, CA 93726-4821
Phone (559) 600-9180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240328000721 CA Practitioner - Marriage and Family Therapist 7719324540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Tulare CurrentSince Jan 29, 2024 Accepting new patients
County of Tulare CurrentSince Jan 29, 2024 Accepting new patients
County of Tulare Current Accepting new patients

Locations

1055 W Henderson Ave
Porterville, CA 93257
Phone (559) 788-1200

520 E Tulare Ave
Visalia, CA 93292

5957 S Mooney Blvd
Visalia, CA 93277
Phone (559) 624-8000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1043234164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 E DAKOTA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 N AIR FRESNO DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271547",
            "telephone_number": "559-600-9180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1925 E Dakota Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937264821",
            "country_code": "US",
            "telephone_number": "559-600-9180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "ERIBERTO",
        "middle_name": "EMILIANO",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "47609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.