Active NPI
Andrea Parisa Mann, D.O.
- Child & Adolescent Psychiatry Physician
- Solana Beach, CA
National Provider Identifier
1518279256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 20A 12789
- Practice address
- 125 N Acacia Ave Ste 107
Solana Beach, CA 92075-1177 - Phone
- (858) 215-1667
- Fax
- (858) 724-1463
- NPI assigned
- Jul 10, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 036.131176 | IL | |
| Psychiatry Physician | 2084P0800X | 20A12789 | CA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 20A 12789 | CA | Primary |
Addresses
Primary practice location
125 N Acacia Ave Ste 107
Solana Beach, CA 92075-1177
Mailing address
125 N Acacia Ave Ste 107
Solana Beach, CA 92075-1177
Phone (858) 215-1667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 29, 2024 through May 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A12789 | CA | MD | Psychiatry Physician |
| 20A 12789 | CA | MD | Child & Adolescent Psychiatry Physician |
| 036.131176 | IL | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andrea Mann, DO, Professional Medical Corporation | Child & Adolescent Psychiatry | Current | Accepting new patients |
Locations
125 N Acacia Ave
Ste 107
Solana Beach, CA 92075
Phone (510) 798-8081
30 N Michigan Ave
Ste 901
Chicago, IL 60602
Phone (312) 339-8604
Interoperability endpoints
- amannmd20897@uchospital.direct-ci.com
Organizations & group practices 1
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.
-
- Child & Adolescent Psychiatry Physician
- Solana Beach, CA
- NPI 1598213316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731456000000",
"number": "1518279256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 N ACACIA AVE STE 107",
"city": "SOLANA BEACH",
"state": "CA",
"postal_code": "920751177",
"telephone_number": "858-215-1667",
"fax_number": "858-724-1463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 N ACACIA AVE STE 107",
"city": "SOLANA BEACH",
"state": "CA",
"postal_code": "920751177",
"telephone_number": "858-215-1667",
"fax_number": "858-724-1463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "ANDREA",
"middle_name": "PARISA",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-10",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "IL",
"license": "036.131176",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "20A12789",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "20A 12789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Solana Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.