Individual
ELICIA MARIE MANRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3201 PULLMAN AVE APT 104, RICHMOND, CA 94804-3174
(510) 383-6699
Mailing address
3201 PULLMAN AVE APT 104, RICHMOND, CA 94804-3174
(510) 383-6699
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BLUECROSS
—
CA
Enumeration date
07/21/2021
Last updated
07/21/2021
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