Edgar Ivan Manzano

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

Practice address

2225 Challenger Way
Santa Rosa, CA 95407-5441

Phone

(707) 565-4970

NPI assigned

Nov 2, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Center Point, Inc.

  • Community Health Clinic/Center
  • San Rafael, CA
  • NPI 1346460607
  NPD (past)
• Healthright 360

  • Substance Abuse Rehabilitation Facility
  • San Francisco, CA
  • NPI 1700920345
  NPD (past)

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1730952573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075441",
            "telephone_number": "707-565-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075441",
            "telephone_number": "707-565-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "EDGAR",
        "middle_name": "IVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-02",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ava Manoochehri, DDS
• Pamela C. Mansfield, LCSW
• Dennis Manthe
• Lisa Ann Manthe, MFT, A.T.R. - BC
• Deanna Manzano
• Unknown Mar Kaw Shu Wa, FNP
• Samantha Marbut, APRN, NP-C
• Renee Marie Marchant
• Luis Antonio Marcos Hardman
• Carrie Marcotte, PT

• Day Training/Habilitation Specialist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Day Training/Habilitation Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.