Man 2 Man Urban Youth Advocate, Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

MAN 2 MAN URBAN YOUTH ADVOCATE, INC

Practice address

5416 Shallows PL W
Santa Rosa, CA 95409-5502

Phone

(408) 750-4334

NPI assigned

Aug 15, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Stewart Bernard Perrilliat II, DMINNPI 1316767221

Title

Executive Director/Ceo

Phone

(408) 750-4334

Specialties & licenses 1

Addresses

Other names 1

• MAN 2 MAN URBAN YOUTH ADVOCATE, INC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stewart Bernard Perrilliat II, DMIN

  • Religious Nonmedical Practitioner
  • Santa Rosa, CA
  • NPI 1316767221
  NPD Authorized official

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1972335255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5416 SHALLOWS PL W",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954095502",
            "telephone_number": "408-750-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5416 SHALLOWS PL W",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954095502",
            "telephone_number": "408-750-4334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Bancroft Ave Ste 266",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946052465",
            "country_code": "US",
            "telephone_number": "510-392-2380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAN 2 MAN URBAN YOUTH ADVOCATE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "PERRILLIAT",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "408-750-4334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DMIN"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAN 2 MAN URBAN YOUTH ADVOCATE, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diane Malnekoff, PHD
• Miriam Maloney-Mattheisen, DNP
• Carrie Jean Maloney, FNP
• Malwa Inc
• Kavita V. Mamtora, MD
• Aryam Raed Manasrah
• Raquel Lynn Mancilla
• Sylvia Mancinas, LVN
• Harold R. Mancusi-Ungaro Jr., MD
• Dorothy Marie Mandel, PSYCHOLOGY LICENSE

• Case Management Agency in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.