Provider Demographics
NPI:1386447910
Name:MACMANNIS, CHRISTOPHER M (CMT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:MACMANNIS
Suffix:
Gender:
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 E HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3162
Mailing Address - Country:US
Mailing Address - Phone:805-698-6350
Mailing Address - Fax:
Practice Address - Street 1:530 E LOS ANGELES AVE STE 210
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-2089
Practice Address - Country:US
Practice Address - Phone:805-531-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-29
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2887225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist