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General NPI Number Information
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NPI Number | 1386045029
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Entity Type | Individual
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Provider Name | DE ANDREA KNIGHT
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Gender | Female
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 05/13/2023
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Provider Practice Location Address
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Address Line | 4100 W ALAMEDA AVE STE 300
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City | BURBANK
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State | CA
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Zip | 91505-4153
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Country | US
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Telephone | 818-600-2086
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Fax |
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Provider Business Mailing Address
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Address Line | 9431 HAVEN AVE STE 100
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5879
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Country | US
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Telephone | 818-600-2086
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 91696
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License Number State | CA
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