Individual provider Active NPI

Manuel Andres Manotas, PSY.D

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1093962185
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26343 Issued in CA
Practice address
999 Sutter St
Suite 206
San Francisco, CA 94109-6023
Phone
(415) 891-9562
NPI assigned
Aug 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY26343 CA Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X

Addresses

Primary practice location

999 Sutter St
Suite 206
San Francisco, CA 94109-6023

Mailing address

6 Snowden LN
Fairfax, CA 94930-1029
Phone (786) 487-5079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY26343CAMDClinical Psychologist
26343CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1093962185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 SNOWDEN LN",
            "city": "FAIRFAX",
            "state": "CA",
            "postal_code": "949301029",
            "telephone_number": "786-487-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 SUTTER ST",
            "address_2": "SUITE 206",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941096023",
            "telephone_number": "415-891-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOTAS",
        "first_name": "MANUEL",
        "middle_name": "ANDRES",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26343",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.