Healthcare Provider Details

I. General information

NPI: 1881533883
Provider Name (Legal Business Name): JENNIFER KNIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4335 ATLANTIC AVE
LONG BEACH CA
90807-2803
US

IV. Provider business mailing address

3616 BARHAM BLVD APT X102
LOS ANGELES CA
90068-1157
US

V. Phone/Fax

Practice location:
  • Phone: 562-216-4900
  • Fax: 562-484-3039
Mailing address:
  • Phone: 562-216-4900
  • Fax: 562-484-3039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: