Individual provider Active NPI

Corina Lozano Manzo, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Marcos, CA
National Provider Identifier
1669087326
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95020369 Issued in CA
Practice address
300 Rancheros Dr Ste 130
San Marcos, CA 92069-2968
Phone
(858) 279-1223
NPI assigned
Sep 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95020369 CA Primary
Registered Nurse 163W00000X 759586 CA
School Registered Nurse 163WS0200X 759586 CA

Addresses

Primary practice location

300 Rancheros Dr Ste 130
San Marcos, CA 92069-2968

Mailing address

300 Rancheros Dr Ste 130
San Marcos, CA 92069-2968
Phone (858) 279-1223

Other practice location 1

7436 Mission Center Road
San Diego, CA 92123
Phone (619) 259-8398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918003032 CA Practitioner - Nurse Practitioner 4688115546 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

300 Rancheros Dr
Suite 130
San Marcos, CA 92069-2968
Phone (858) 279-1223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego American Indian Health Center CurrentSince Aug 7, 2024 Accepting new patients
Pacific Coast Psychiatric Associates Inc CurrentSince Oct 7, 2025 Accepting new patients

Locations

8881 Fletcher Pkwy
Ste 350
La Mesa, CA 91942
Phone (619) 465-9792

2602 1st Ave
Ste 105
San Diego, CA 92103

2630 1st Ave
San Diego, CA 92103
Phone (619) 234-2158

2630 1st Ave
Ste 211
San Diego, CA 92103

300 Rancheros Dr
Ste 130
San Marcos, CA 92069

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFGCCD
  • Direct secure messaging: lifestancehealth.corinamanzo@143255.advancedmd-direct.com

Organizations & group practices 2

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": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1669087326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RANCHEROS DR STE 130",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692968",
            "telephone_number": "858-279-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RANCHEROS DR STE 130",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692968",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7436 Mission Center Road",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92123",
            "country_code": "US",
            "telephone_number": "619-259-8398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANZO",
        "first_name": "CORINA",
        "middle_name": "LOZANO",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020369",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "759586",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "759586",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.