Provider Demographics
NPI:1003935271
Name:KNIGHT, ATHENA DEANN
Entity type:Individual
Prefix:
First Name:ATHENA
Middle Name:DEANN
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ATHENA
Other - Middle Name:DEANN
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:49515 MICHAEL AVE
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-1510
Mailing Address - Country:US
Mailing Address - Phone:661-822-4885
Mailing Address - Fax:760-373-2980
Practice Address - Street 1:8101 BAY AVE
Practice Address - Street 2:
Practice Address - City:CALIFORNIA CITY
Practice Address - State:CA
Practice Address - Zip Code:93505-2695
Practice Address - Country:US
Practice Address - Phone:760-373-2979
Practice Address - Fax:760-373-2980
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor