Carla Marie Manly, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 25539 Issued in CA

Practice address

405 Chinn St Ste 102
Santa Rosa, CA 95404-4311

Phone

(707) 236-0012

NPI assigned

Apr 4, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1619266343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 4TH ST",
            "address_2": "PMB #171",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054726",
            "telephone_number": "707-236-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CHINN ST STE 102",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044311",
            "telephone_number": "707-236-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLY",
        "first_name": "CARLA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 25539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Anthony Legaspi Maningas
• David Maniscalco, M.D.
• Sneha Sowrabha Bangra Manjeshwar
• Kelsey Manley
• Stephanie Manley
• Deborah Mannle
• Ava Manoochehri, DDS
• Pamela C. Mansfield, LCSW
• Dennis Manthe
• Lisa Ann Manthe, MFT, A.T.R. - BC

• Clinical Psychologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.