Individual provider · Type 1 NPI
Mark Patrick Manning
Psychiatric/Mental Health Nurse Practitioner · San Diego, CA
NPI number
1417439647
Active
Practice location
5252 Balboa Ave Ste 803
San Diego, CA 92117-6920
Fax (619) 204-6087
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95009680 (CA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95009680 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1417439647
Mark Patrick Manning's National Provider Identifier is 1417439647, issued on Sep 4, 2018. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in San Diego, CA. The record was last updated on Jan 5, 2026.