Active NPI
Manal Siddiq, MS, IMF
- Mental Health Counselor
- La Mesa, CA
National Provider Identifier
1740300409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 47786
- Practice address
- 7339 El Cajon Blvd Ste K
La Mesa, CA 91941-3435 - Phone
- (619) 668-6200
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 47786 | CA | Primary |
Addresses
Primary practice location
7339 El Cajon Blvd Ste K
La Mesa, CA 91941-3435
Mailing address
10815 Caminito Arcada
San Diego, CA 92131-3666
Phone (510) 206-1099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47786 | CA | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740300409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10815 CAMINITO ARCADA",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921313666",
"telephone_number": "510-206-1099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7339 EL CAJON BLVD STE K",
"city": "LA MESA",
"state": "CA",
"postal_code": "919413435",
"telephone_number": "619-668-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDDIQ",
"first_name": "MANAL",
"name_prefix": "Mrs.",
"credential": "MS, IMF",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "47786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
- Shota Gurtch, M.D., Inc. a Professional Corporation
- Shota Gurtch, M.D., Inc., a Professional Corporation
- Shota Gurtch, M.D., Inc., a Professional Corporation
- Victoria G. Shuffelton, D.O.
- Bonnie Beth Shuman
- Shabana Anjum Siddiqui, MD
- Andrew Jason Siegel, MS
- Silva Family Therapy Inc
- Bradley Kent Silva, D.D.S.
- Cara Silva, MA, MFTI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.