Our Providers
Zachary Cruz, PMHNP-BC, MSN, RN
Psychiatric Nurse Practitioner
Hi, I’m Zachary Cruz. I am dedicated to providing compassionate, collaborative, and evidence-based mental health care. I believe the foundation of good psychiatric care is trust, and my goal is to create a welcoming, judgment-free environment where you feel heard, understood, and empowered to take an active role in your mental health journey.
Before becoming a PMHNP, I served as a firefighter and have more than six years of nursing experience, including extensive work within the Veterans Health Administration caring for individuals living with a wide range of mental health conditions such as anxiety, depression, PTSD, bipolar disorder, schizophrenia, ADHD, and trauma-related disorders. Those experiences taught me that mental health is deeply connected to every aspect of a person’s life. I learned the importance of treating the whole person—not just a diagnosis—by recognizing how physical health, relationships, life experiences, and personal strengths all influence emotional well-being. I also have experience in clinical education, which has strengthened my commitment to lifelong learning and providing the highest quality evidence-based care.
My passion for psychiatry grew from the relationships I built throughout my nursing career. I realized that some of the greatest challenges people face aren’t only physical—they’re emotional, psychological, and deeply personal. I wanted the opportunity to build lasting therapeutic relationships and support people through those challenges with compassionate, comprehensive mental health care. My approach begins with listening. Every person has a unique story, and before recommending a treatment plan, I want to understand your experiences, your goals, what’s helped in the past, and what matters most to you.
I believe medication is one important tool—but not the only one. I practice thoughtful, evidence-based medication management while incorporating patient education, shared decision-making, therapy when appropriate, and healthy lifestyle strategies to create a treatment plan tailored to your individual needs.
My hope is that every person leaves our appointments feeling heard, respected, supported, and more hopeful than when they arrived. Even if we don’t solve everything in one visit, I want you to leave knowing you have a clear plan and someone who is genuinely invested in helping you achieve lasting mental wellness. Outside of work, I enjoy spending time with my family and being a father. I’m honored to be part of Flow Theory Psychiatry and look forward to partnering with you on your journey toward improved mental health and overall well-being.
Kirsten Manalo, PMHNP-BC, DNP, RN
Founder, Owner, CEO, Psychiatric Nurse Practitioner
Hi, I’m Kirsten. With nearly a decade of nursing experience, I've had the privilege of caring for patients across a variety of healthcare settings, including inpatient and outpatient psychiatry, medical-surgical nursing, home health, academia, and private practice. These experiences have reinforced my belief that every person's story is unique and that meaningful mental health care requires looking beyond symptoms alone.
I work with adults experiencing depression, anxiety, ADHD, trauma-related conditions, and other common mental health concerns. Whether you're seeking support for the first time or have tried treatment before without the results you hoped for, my goal is to create a space where you feel heard, respected, and actively involved in your care.
I take a whole-person approach using the biopsychosocial model, recognizing that mental health is influenced by biological, psychological, social, lifestyle, and, when meaningful to you, spiritual factors. Rather than relying on a one-size-fits-all approach, I work collaboratively with each patient to develop a personalized treatment plan that reflects their unique goals, values, and preferences.
I believe quality psychiatric care begins with listening. During our appointments, I take the time to understand your concerns, formulate an accurate diagnosis, provide education about your condition and treatment options, answer your questions, and empower you to make informed decisions about your care. My hope is that you leave each visit feeling understood, supported, and confident in the path we're creating together.
Medications can be a valuable tool to help to manage symptoms in the short-term, but I believe that positive long-lasting effects of treatment lie in addressing the root-causes of these symptoms and proactively working through each to overcome them one-by-one. My treatment approach goes beyond symptom management, it focuses on healing, recovery, and empowerment of each individual so they can get to a better place in life.
One belief that has deeply influenced my work is that genuine empathy comes from both professional training and lived experience. Like many people, I've experienced my own challenges and periods of personal growth, which have given me a deeper appreciation for how difficult it can be to ask for help, navigate uncertainty, and work toward healing.
While every person's journey is unique, my own experiences have strengthened my ability to meet patients with compassion rather than judgment. I strive to create a space where you feel safe, understood, and supported, because I believe meaningful healing begins with feeling truly seen and heard.
Outside of work, I enjoy spending time with loved ones, playing with my dog, surfing, traveling, and being outdoors. I believe that caring for our mental health isn't limited to what happens in a therapy or psychiatry appointment—it also comes from nurturing meaningful relationships, engaging in activities that bring us joy, and creating a life that feels balanced and fulfilling. That's a philosophy I strive to practice in my own life and encourage in the patients I care for.
Practicing in collaboration with a licensed physician in accordance with California law.
