Provider Demographics
NPI:1295244218
Name:KNOX-WARD, CHENENA RASHELLE
Entity type:Individual
Prefix:MRS
First Name:CHENENA
Middle Name:RASHELLE
Last Name:KNOX-WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHENENA
Other - Middle Name:R
Other - Last Name:KNOXWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACSW91411
Mailing Address - Street 1:5811 E BYRD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727
Mailing Address - Country:US
Mailing Address - Phone:559-351-8336
Mailing Address - Fax:
Practice Address - Street 1:4411 N CEDAR AVE STE 108
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-2538
Practice Address - Country:US
Practice Address - Phone:559-248-1548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104100000X, 390200000X
106H00000X, 390200000X, 101YM0800X
CAASW91411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty