Individual
LISA GAY MANESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHIATRIC TECH
Contact information
Practice address
115 E FESLER ST, SANTA MARIA, CA 93454-4404
(805) 357-5195
Mailing address
4615 HARMONY LANE, ORCUTT, CA 93455
(805) 423-1026
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
32478
CA
Other
Enumeration date
12/07/2022
Last updated
06/24/2023
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