Healthcare Provider Details

I. General information

NPI: 1497369078
Provider Name (Legal Business Name): VANESSA RACHAEL NETTELHORST KNIGHT MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VANESSA RACHAEL NETTELHORST MA

II. Dates (important events)

Enumeration Date: 09/01/2020
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7120 N MARKS AVE UNIT 110
FRESNO CA
93711-0268
US

IV. Provider business mailing address

8605 SANTA MONICA BLVD PMB 726600
WEST HOLLYWOOD CA
90069-4109
US

V. Phone/Fax

Practice location:
  • Phone: 559-439-5437
  • Fax:
Mailing address:
  • Phone: 818-626-4037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: