Jane E Manning, P.A.

Individual provider Active NPI Medical Physician Assistant · Willow Creek, CA

NPI 1376674598 · NPPES record last updated Mar 7, 2017

Key facts

NPI
1376674598
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
PA 11573 (CA)
Practice address
38883 Hwy 299
Box 726
Willow Creek, CA 95573-0726
Phone
(530) 629-3111
Fax
(530) 629-3122
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 11573CAMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 11573 CA Yes

Addresses

Primary practice location

38883 Hwy 299
Box 726
Willow Creek, CA 95573-0726

Mailing address

670 9TH St
Suite 203
Arcata, CA 95521-6248
Phone (707) 826-8633

Other providers in Willow Creek, CA

All providers in Willow Creek, CA · Medical Physician Assistant in California

Sources for this page

Verify at the official NPI Registry.