Etianne Camille Manetta, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY35217 Issued in CA

Practice address

1350 Columbia St Unit 402
San Diego, CA 92101-3455

Phone

(619) 393-1447

NPI assigned

Sep 2, 2024

Last updated

Sep 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Daniel Blaess, PH.D., Psychologist, Inc.Group PAC ID 0941247662, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daniel Blaess, PH.D., Psychologist, Inc.

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1225162274
  Medicare reassignment Care Compare group NPD
• Manetta Psychology Apc

  • Clinical Psychologist
  • La Jolla, CA
  • NPI 1215847439
  Authorized official Same address or phone

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

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1669207510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 COLUMBIA ST UNIT 402",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 COLUMBIA ST UNIT 402",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013455",
            "telephone_number": "619-393-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANETTA",
        "first_name": "ETIANNE",
        "middle_name": "CAMILLE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Maneen, RN
• Jennifer Renee Maneffa, MSN, APRN, FNP-C
• Trina Marie Manes, MD
• Joleysa Anne Silva Manese, DO
• Dennis Maness, PH.D.
• Monique Manisha Mangal, LVN
• Kristin Mangalindan
• Rico Mangalindan
• Denise Mangalino
• James K Mangan, MD

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.