Provider Demographics
NPI:1528715174
Name:NAVARRO, MANUEL YVAN
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:YVAN
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 3RD ST STE 1C
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-1444
Mailing Address - Country:US
Mailing Address - Phone:415-437-3990
Mailing Address - Fax:
Practice Address - Street 1:1312 104TH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94603-3119
Practice Address - Country:US
Practice Address - Phone:510-875-8541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator