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

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