Healthcare Provider Details

I. General information

NPI: 1912028036
Provider Name (Legal Business Name): MRS. DELPHINA KNAPP I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DELPHINA KNAPP I BACHELORS DEGREE

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 W 149TH ST
GARDENA CA
90247
US

IV. Provider business mailing address

14517 CRENSHAW BLVD
GARDENA CA
90249-3144
US

V. Phone/Fax

Practice location:
  • Phone: 310-217-9560
  • Fax:
Mailing address:
  • Phone: 310-217-9550
  • Fax: 310-217-9551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: