Healthcare Provider Details

I. General information

NPI: 1740623487
Provider Name (Legal Business Name): VANESSA LYNN KNIPPEL M.A., LMFT 53937
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VANESSA LYNN LEMMINGER

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 W MAIN AVE STE 201
DE PERE WI
54115-1695
US

IV. Provider business mailing address

3978 SORRENTO VALLEY BLVD SUITE 100
SAN DIEGO CA
92121-1436
US

V. Phone/Fax

Practice location:
  • Phone: 920-338-1610
  • Fax: 920-338-1616
Mailing address:
  • Phone: 858-847-8429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1222-124
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: