Provider Demographics
NPI:1689418469
Name:MANZANERO, BRIANA (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:MANZANERO
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14500 ROSCOE BLVD FL 4FLOOR
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4190
Mailing Address - Country:US
Mailing Address - Phone:818-446-5222
Mailing Address - Fax:
Practice Address - Street 1:14500 ROSCOE BLVD FL 4FLOOR
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4190
Practice Address - Country:US
Practice Address - Phone:818-446-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT-02213546246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy