Inessa Manevich, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS017176 Issued in PA

Practice address

1150 Yale St
Suite 2
Santa Monica, CA 90403-4738

Phone

(310) 804-6339

NPI assigned

Mar 23, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 26, 2020 through Oct 26, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1285900217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 YALE ST",
            "address_2": "SUITE 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034738",
            "telephone_number": "310-804-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 YALE ST",
            "address_2": "SUITE 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034738",
            "telephone_number": "310-804-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANEVICH",
        "first_name": "INESSA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017176",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017176",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 25319",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richelle Mancewicz, M.A., LMFT
• Lee Chaidez Mancilla, PA-C
• Davinder Singh Mand, MD
• Michael Mandel, M.D.
• Bert R Mandelbaum, M.D.
• Megan Mangano, RDN
• Heidi K Manheim
• Kevin Hitesh Maniar
• Natalie Laura Manitius, MPH, RDN
• Omar Farouk Manjoo, RPH

• Clinical Psychologist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.