Provider Demographics
NPI:1104309558
Name:MCMANUS, ADRIANNA MARIE (ATC)
Entity type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:MARIE
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 EL CAMINO REAL
Mailing Address - Street 2:STE M384 OFFICE 230
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304
Mailing Address - Country:US
Mailing Address - Phone:650-441-2135
Mailing Address - Fax:
Practice Address - Street 1:180 EL CAMINO REAL
Practice Address - Street 2:STE M384 OFFICE 230
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304
Practice Address - Country:US
Practice Address - Phone:650-441-2135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20000258622255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer