Active NPI
Christina Luella Manildi, P.A.
- Physician Assistant
- Santa Cruz, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17668
- Practice address
- 1667 Dominican Way
Suite 134
Santa Cruz, CA 95065-1518 - Phone
- (831) 475-8834
- Fax
- (831) 475-1014
- NPI assigned
- Oct 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17668 | CA | Primary |
| Medical Physician Assistant | 363AM0700X | PA17668 | CA |
Addresses
Primary practice location
1667 Dominican Way
Suite 134
Santa Cruz, CA 95065-1518
Mailing address
3160 Folsom Blvd
Sacramento, CA 95816-5219
Phone (916) 733-5701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
160 Green Valley Rd
Suite 201
Freedom, CA 95019-3160
Phone (831) 458-5865
2025 Soquel Ave
Santa Cruez, CA 95062-1323
Phone (831) 423-4111
550 S Green Valley Rd
Watsonville, CA 95076-3053
Phone (831) 458-5865
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17668 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Sutter East Bay Medical Foundation | Past | Accepting new patients |
Locations
3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800
370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200
795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832
795 El Camino Real
#1112
Palo Alto, CA 94301
290 Redwood Shores Pkwy
Redwood City, CA 94065
Phone (650) 598-3160
123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200
2025 Soquel Ave
Santa Cruz, CA 95062
Phone (408) 423-4111
1667 Dominican Way
Ste 134
Santa Cruz, CA 95065
Phone (831) 475-8834
550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Palo Alto, CA
- NPI 1013950807
-
- Multi-Specialty Clinic/Center
- Sacramento, CA
- NPI 1003267196
-
- Clinical Medical Laboratory
- Santa Clara, CA
- NPI 1669287033
-
- General Acute Care Hospital
- Santa Cruz, CA
- NPI 1427181007
-
- Family Medicine Physician
- Orinda, CA
- NPI 1871538769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193270400000",
"number": "1316126436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3160 FOLSOM BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165219",
"telephone_number": "916-733-5701",
"fax_number": "916-859-1671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1667 DOMINICAN WAY",
"address_2": "SUITE 134",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950651518",
"telephone_number": "831-475-8834",
"fax_number": "831-475-1014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANILDI",
"first_name": "CHRISTINA",
"middle_name": "LUELLA",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-25",
"last_updated": "2007-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17668",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA17668",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.