Provider Demographics
NPI:1699926360
Name:MANGLONA, NORMAN VINCENT DIAZ
Entity type:Individual
Prefix:
First Name:NORMAN VINCENT
Middle Name:DIAZ
Last Name:MANGLONA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2525
Mailing Address - Country:US
Mailing Address - Phone:415-355-8300
Mailing Address - Fax:
Practice Address - Street 1:1520 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2525
Practice Address - Country:US
Practice Address - Phone:415-355-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker