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Individual

MASHA MANKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13200 CROSSROADS PKWY N, CITY OF INDUSTRY, CA 91746-3459
(562) 821-9603
Mailing address
30 CATANIA, MISSION VIEJO, CA 92692-5126
(949) 338-7811

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6727
CA
Enumeration date
03/02/2022
Last updated
03/02/2022
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