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1275498305 NPI number — JENNIFER KNOLL MA, MT-BC

NPI Number: 1275498305
Health Care Provider/Practitioner: JENNIFER KNOLL MA, MT-BC

Information about “1275498305” NPI (JENNIFER KNOLL MA, MT-BC) exists in 1275498305 in HTML format HTML  |  1275498305 in plain Text format TXT  |  1275498305 in PDF (Portable Document Format) PDF  |  1275498305 in an XML format XML  formats.

NPI Number : 1275498305 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1275498305",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KNOLL",
    "FirstName": "JENNIFER",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MA, MT-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WITHEY",
    "OtherFirstName": "JENNIFER",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MT-BC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "308 N WANDA DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FULLERTON",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92833-2648",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "562-477-8989",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3933 HARRISON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RIVERSIDE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92503-3523",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "833-391-0505",
    "PracticeLocationAddressFaxNumber": "951-358-4716",
    "EnumerationDate": "12/20/2025",
    "LastUpdateDate": "12/20/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225A00000X",
        "TaxonomyName": "Music Therapist",
        "LicenseNumber": "14561",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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