Active NPI
Jonathan Manzano, CMT
- Massage Therapist
- Sanger, CA
National Provider Identifier
1467042614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 84361
- Practice address
- 104 Faller Ave
Sanger, CA 93657 - Phone
- (559) 908-3393
- NPI assigned
- Jan 21, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 84361 | CA | Primary |
Addresses
Primary practice location
104 Faller Ave
Sanger, CA 93657
Mailing address
104 Faller Ave
Sanger, CA 93657-2185
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84361 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1467042614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 FALLER AVE",
"city": "SANGER",
"state": "CA",
"postal_code": "936572185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 FALLER AVE",
"city": "SANGER",
"state": "CA",
"postal_code": "93657",
"telephone_number": "559-908-3393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZANO",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-21",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "84361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sanger, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.