Provider Demographics
NPI:1629231030
Name:KNAUSS, MALIA (OTR)
Entity Type:Individual
Prefix:
First Name:MALIA
Middle Name:
Last Name:KNAUSS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:WHITLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:107 N REINO RD STE 1051
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-3710
Mailing Address - Country:US
Mailing Address - Phone:805-558-7638
Mailing Address - Fax:
Practice Address - Street 1:3575 N MOORPARK RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-2666
Practice Address - Country:US
Practice Address - Phone:805-244-6722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2022-09-20
Deactivation Date:2022-08-28
Deactivation Code:
Reactivation Date:2022-09-20
Provider Licenses
StateLicense IDTaxonomies
CA10206225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist