Healthcare Provider Details

I. General information

NPI: 1396996468
Provider Name (Legal Business Name): HERSCHEL KNAPP PH.D., M.S.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD BLDG. 500, OFFICE 4681
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

1426 ARMACOST AVE APT 2
LOS ANGELES CA
90025-2222
US

V. Phone/Fax

Practice location:
  • Phone: 310-478-3711
  • Fax: 310-268-4928
Mailing address:
  • Phone: 310-473-2625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27280
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: