Individual
JACQUES MANNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
954 60TH ST, OAKLAND, CA 94608-2369
(510) 835-5532
(510) 653-4207
Mailing address
954 60TH ST, OAKLAND, CA 94608-2369
(510) 835-5532
(510) 653-4207
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
0136
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0136
17 OTHER
CA
Enumeration date
04/09/2009
Last updated
04/09/2009
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