Provider Demographics
NPI:1972218535
Name:MANRESA WELLNESS
Entity type:Organization
Organization Name:MANRESA WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:C
Authorized Official - Last Name:RITSEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-612-6283
Mailing Address - Street 1:9515 SOQUEL DR STE 207
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4137
Mailing Address - Country:US
Mailing Address - Phone:831-612-6283
Mailing Address - Fax:877-677-2791
Practice Address - Street 1:9515 SOQUEL DR STE 207
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4137
Practice Address - Country:US
Practice Address - Phone:831-612-6283
Practice Address - Fax:877-677-2791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty