Provider Demographics
NPI:1558742841
Name:KNOX, MARY CHRISTINE
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:CHRISTINE
Last Name:KNOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:KNOX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:270 COUNTY HOSPITAL RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971-9180
Mailing Address - Country:US
Mailing Address - Phone:530-283-6307
Mailing Address - Fax:530-283-6045
Practice Address - Street 1:270 COUNTY HOSPITAL RD
Practice Address - Street 2:SUITE 109
Practice Address - City:QUINCY
Practice Address - State:CA
Practice Address - Zip Code:95971-9180
Practice Address - Country:US
Practice Address - Phone:530-283-6307
Practice Address - Fax:530-283-6045
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLSW2469-S171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator