Provider Demographics
NPI:1659934909
Name:KNAPP, LOURDES ROCIO DIAZ (RN)
Entity Type:Individual
Prefix:
First Name:LOURDES ROCIO
Middle Name:DIAZ
Last Name:KNAPP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WATER ST STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2792
Mailing Address - Country:US
Mailing Address - Phone:831-427-3582
Mailing Address - Fax:
Practice Address - Street 1:21507 E CLIFF DR
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4844
Practice Address - Country:US
Practice Address - Phone:831-427-3500
Practice Address - Fax:831-427-7785
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023688163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health