Provider Information for 1396218913
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Mrs. ELENA ANNIE MANUCHARYAN LCSW #115661
Sex: Female
NPI: 1396218913
Last Updated: 2024-03-20
Certification Date: 2024-03-20
Certification Date: 2024-03-20
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1396218913 | ||||||||||||
| Enumeration Date | 2019-01-07 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1823 E QUINCY AVE FRESNO, CA 93720-2354 United States Phone: 559-269-0416 | Fax: | ||||||||||||
| Primary Practice Address | 5610 W DONNER AVE FRESNO, CA 93722-3721 United States Phone: 559-352-0860 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 209 E 7TH ST 3455 W SHAW AVE STE 107 7658 N SANTA FE AVE | ||||||||||||
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