Provider Demographics
NPI:1730629502
Name:MANIPON, CHERIFER
Entity type:Individual
Prefix:
First Name:CHERIFER
Middle Name:
Last Name:MANIPON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 N VULCAN AVE
Mailing Address - Street 2:STE 208
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2190
Mailing Address - Country:US
Mailing Address - Phone:760-634-1125
Mailing Address - Fax:760-634-1530
Practice Address - Street 1:721 N VULCAN AVE
Practice Address - Street 2:STE 208
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2190
Practice Address - Country:US
Practice Address - Phone:760-634-1125
Practice Address - Fax:760-634-1530
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health