Active NPI
Evelyn Elide Mancha, PHARMD
- Pharmacist
- Stockton, CA
National Provider Identifier
1992585756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 88427
- Practice address
- 2040 East Mariposa Road
Stockton, CA 95205 - Phone
- (209) 601-5722
- NPI assigned
- Sep 29, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 88427 | CA | Primary |
Addresses
Primary practice location
2040 East Mariposa Road
Stockton, CA 95205
Mailing address
2373 Hall Ave
Stockton, CA 95205-8420
Phone (209) 601-0572
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88427 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695945600000",
"number": "1992585756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2373 HALL AVE",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952058420",
"telephone_number": "209-601-0572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 EAST MARIPOSA ROAD",
"city": "STOCKTON",
"state": "CA",
"postal_code": "95205",
"telephone_number": "209-601-5722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCHA",
"first_name": "EVELYN",
"middle_name": "ELIDE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-29",
"last_updated": "2023-09-29",
"certification_date": "2023-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "88427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.