Healthcare Provider Details

I. General information

NPI: 1972423382
Provider Name (Legal Business Name): ABEGAYLE SOSHANNA KNOWLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 CASSIDY ST
OCEANSIDE CA
92054-5314
US

IV. Provider business mailing address

561 MEADOWOOD ST
FALLBROOK CA
92028-6576
US

V. Phone/Fax

Practice location:
  • Phone: 760-721-2171
  • Fax:
Mailing address:
  • Phone: 203-200-9960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number47659
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: