Provider Demographics
NPI:1285783936
Name:MANUGUERRA, ANNAMARIA (SPEECH LANGUAGE PATH)
Entity type:Individual
Prefix:
First Name:ANNAMARIA
Middle Name:
Last Name:MANUGUERRA
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4560 SE INTERNATIONAL WAY
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222
Mailing Address - Country:US
Mailing Address - Phone:971-206-5140
Mailing Address - Fax:971-206-5209
Practice Address - Street 1:2387 WESTGATE AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-4038
Practice Address - Country:US
Practice Address - Phone:831-601-0480
Practice Address - Fax:971-206-5209
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14387235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist