Healthcare Provider Details

I. General information

NPI: 1942897947
Provider Name (Legal Business Name): INGA HELEN KNUDSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 BUTLER LN STE 207
SCOTTS VALLEY CA
95066-3550
US

IV. Provider business mailing address

6001 BUTLER LN STE 207
SCOTTS VALLEY CA
95066-3550
US

V. Phone/Fax

Practice location:
  • Phone: 669-240-3419
  • Fax:
Mailing address:
  • Phone: 669-240-3419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number159944
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: