Individual
MR. DENNIS MANESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3978 SORRENTO VALLEY BLVD, #310, SAN DIEGO, CA 92121-1436
(858) 222-9138
(858) 385-0222
Mailing address
3978 SORRENTO VALLEY BLVD, #310, SAN DIEGO, CA 92121-1436
(858) 222-9138
(858) 385-0222
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2457 BCN
CA
101YM0800X
Mental Health Counselor
2457 BCN
CA
103G00000X
Clinical Neuropsychologist
Primary
2457 BCN
CA
103K00000X
Behavior Analyst
2457 BCN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2457 BCN
BOARD CERTIFIED NEUROTHERAPIST
CA
Enumeration date
04/29/2013
Last updated
04/29/2013
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