Healthcare Provider Details

I. General information

NPI: 1497079172
Provider Name (Legal Business Name): CA'SHA LAVETTE KNIGHT MSN, ARNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

669 N. LOS ROBLES AVENUE
PASADENA CA
91101
US

IV. Provider business mailing address

669 N. LOS ROBLES AVENUE
PASADENA CA
91101
US

V. Phone/Fax

Practice location:
  • Phone: 626-644-6563
  • Fax:
Mailing address:
  • Phone: 626-644-6563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number753377-CERTIFIED NUR
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: