Provider Demographics
NPI:1174771307
Name:MANN, CATALINA MARTINEZ (ADC)
Entity type:Individual
Prefix:MRS
First Name:CATALINA
Middle Name:MARTINEZ
Last Name:MANN
Suffix:
Gender:F
Credentials:ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7993 SIERRA AVENUE SUITE K
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92376-2850
Mailing Address - Country:US
Mailing Address - Phone:909-822-8720
Mailing Address - Fax:909-822-8438
Practice Address - Street 1:7993 SIERRA AVE
Practice Address - Street 2:SUITE K
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-3330
Practice Address - Country:US
Practice Address - Phone:909-822-8720
Practice Address - Fax:909-822-8438
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2464060171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4757OtherTEMPORARY PIN