Individual provider Active NPI

Andrea Parisa Mann, D.O.

  • Child & Adolescent Psychiatry Physician
  • Solana Beach, CA
National Provider Identifier
1518279256
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
20A 12789 Issued in CA
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

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.
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

LicenseStateTypeSpecialty
20A12789CAMDPsychiatry Physician
20A 12789CAMDChild & Adolescent Psychiatry Physician
036.131176ILMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea Mann, DO, Professional Medical Corporation Child & Adolescent Psychiatry CurrentSince Nov 17, 2024 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.