Healthcare Provider Details

I. General information

NPI: 1639839525
Provider Name (Legal Business Name): CIARA KNERR CNM, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2021
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16105 SAND CANYON AVE STE 200
IRVINE CA
92618-3779
US

IV. Provider business mailing address

14262 MATISSE AVE
IRVINE CA
92606-1820
US

V. Phone/Fax

Practice location:
  • Phone: 949-829-5500
  • Fax:
Mailing address:
  • Phone: 702-354-5431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number236231
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: