Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Benjamin Morales Manacop III

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1750152344

Benjamin Morales Manacop III is a Nurse Practitioner in Colton, California. Qualified in 2023, 3 years ago. Accepts Medicare assignment. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2024
Specialties on file
2

Practice location Address checks out

1007 E Cooley Dr Ste 103
Colton, CA 92324-3901
Phone: (951) 727-6460
Fax: (909) 219-5336
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95030284 (CA)
Oncology Registered Nurse Taxonomy 163WX0200X · Licence 631790 (CA)

Record details

NPI number1750152344
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 11, 2024
Last updated in NPPESJanuary 12, 2026
Certification dateJanuary 12, 2026
Mailing address1007 E Cooley Dr Ste 103, Colton, CA 92324-3901

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Colton