Healthcare Provider Details

I. General information

NPI: 1952581381
Provider Name (Legal Business Name): MAUREAN ANNE MCKNIGHT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAUREAN ANNE HECHTER

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19825 VENTURA BLVD
WOODLAND HILLS CA
91364-2627
US

IV. Provider business mailing address

19825 VENTURA BLVD
WOODLAND HILLS CA
91364-2627
US

V. Phone/Fax

Practice location:
  • Phone: 818-340-3636
  • Fax: 818-340-9241
Mailing address:
  • Phone: 818-340-3636
  • Fax: 818-340-9241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA11844
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: