MATILDA MANKA MANGAN (NPI# 1972035442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972035442 |
| Entity Type | Individual |
| Full Name | MATILDA MANKA MANGAN |
| Credential | NP |
| Practice Address |
42756 Portraits Ln Temecula CA 92592 |
| Practice Telephone | 9493513238 |
| Mailing Telephone | 9493513238 |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
NP95006288 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
NP95006288 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
42756 PORTRAITS LN |
| City | TEMECULA |
| State | CA |
| Zip Code | 92592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366051625 | Huey Q Tran, Dds, Inc. | Dentist | 33321 Temecula Parkway Ste 104, Temecula, CA 92592 | 2020-07-23 |
| 1902425465 | Isak Elkayam | Student in an Organized Health Care Education/Training Program | 31700 Temecula Parkway, Parkway Suites # 2- Gme, Temecula, CA 92592 | 2020-04-14 |
| 1033738737 | Jordan Buckley | Student in an Organized Health Care Education/Training Program | Uhs Socal Medical Education Consortium, 31700 Temecula Parkway Parkway Suites # 2- Gme, Temecula, CA 92592 | 2020-04-13 |
| 1366071052 | Areg Hovsepyan | Internal Medicine | 31700 Temecula Parkway Parkway Suites # 2- Gme, Temecula, CA 92592 | 2020-04-03 |
| 1558906982 | Session Sync, Inc. | Point of Service | 44262 Marcelina Court, Temecula, CA 92592 | 2019-11-08 |
| 1962964718 | Krishna Theja Reddy Venkatamuni Reddy | Student in an Organized Health Care Education/Training Program | Uhs Socal Medical Education Consortium, 31700 Temecula Parkway, Parkway Suites # 2- Gme, Temecula, CA 92592 | 2019-04-02 |
| 1598220246 | Shanay Lamont Moore | Behavior Technician | 30660 Milky Way Dr., V174, Temecula, CA 92592 | 2019-02-07 |
| 1477029502 | Tibbitts Temecula Dental Group | Clinic/Center | 32909 Temecula Parkway Ste 102, Temecula, CA 92592 | 2018-10-16 |
| 1720563364 | Nicole Louise Hernandez | Behavioral Analyst | 32144 Camino Nunez, Temecula, CA 92592 | 2018-09-29 |
| 1174010664 | Kiet Chau | Pharmacist | 32228 Highway 79 South, Temecula, CA 92592 | 2018-04-19 |
| Find all providers in zip 92592 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730722034 | Jessica Montoya | Nurse Practitioner | 27290 Madison Ave Ste 102, Temecula, CA 92590-5672 | 2019-10-20 |
| 1851561054 | Michelle Von Snyder | Nurse Practitioner | 31720 Temecula Parkway, Temecula Valley Clinic, Temecula, CA 92592 | 2008-03-04 |
| 1447369244 | Karen Kay Larcher-rowland | Nurse Practitioner | 32605 Temecula Pkwy, #219, Temecula, CA 92592-6837 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699388504 | Daniel Ngo | Nurse Practitioner | 1180 S Hilda St, Anaheim, CA 92806-5007 | 2020-08-28 |
| 1407464522 | Laura Bradigan | Nurse Practitioner | 1744 Grand Ave Unit 2, Long Beach, CA 90804-2022 | 2020-07-15 |
| 1538787031 | Kelly Olcott | Nurse Practitioner | 4004 Via Lucero Apt 12, Santa Barbara, CA 93110-1692 | 2020-07-10 |
| 1629695440 | Kelley Ibarra | Nurse Practitioner | 1613 Celeste Dr, Modesto, CA 95355-5039 | 2020-06-26 |
| 1497379333 | Gloria Jean Campbell | Nurse Practitioner | 5055 E Garford St Apt 6, Long Beach, CA 90815-2861 | 2020-06-06 |
| 1851913115 | Lilly Fong | Nurse Practitioner | 15821 Square Top Ln, Fontana, CA 92336-4586 | 2020-05-09 |
| 1548880750 | Sharkeiya Terrell | Nurse Practitioner | 2752 Harrison Ave Ste A, Eureka, CA 95501-4738 | 2020-04-17 |
| 1730714007 | Julissa Leonides Caraballo | Nurse Practitioner | 4044 Promontory St, San Diego, CA 92109-5334 | 2020-03-07 |
| 1194355404 | Bethany Leda Donowho | Nurse Practitioner | 845 Via De La Paz Ste 16, Pacific Palisades, CA 90272-3627 | 2020-01-26 |
| 1518507078 | Rachel Saake Collar | Nurse Practitioner | 5100, 1000 Executive Pkwy, Oroville, CA 95966 | 2020-01-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.