Individual
DR. BRADLEY A MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
595 E COLORADO BLVD STE 635, PASADENA, CA 91101-2032
(626) 797-0305
(310) 398-8303
Mailing address
595 EAST COLORADO BLVD., SUITE 635, PASADENA, CA 91101-2032
(626) 797-0305
(310) 398-8303
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 7354
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY 073540
—
CA
Enumeration date
06/19/2007
Last updated
07/08/2007
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