Individual
MARY CAROLINE E. MACAM MANALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
701 PLEASANT GROVE BLVD #125, ROSEVILLE, CA 95678
(916) 784-7700
Mailing address
6511 NEBULA CT, ROCKLIN, CA 95677
(951) 756-3618
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP95016452
CA
Other
Enumeration date
01/31/2021
Last updated
01/31/2021
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