Provider Demographics
NPI:1396978508
Name:KNOPF, CHERIE (ADMINISTRATOR)
Entity type:Individual
Prefix:MISS
First Name:CHERIE
Middle Name:
Last Name:KNOPF
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24310 MOULTON PKWY
Mailing Address - Street 2:SUITE O-618
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-3306
Mailing Address - Country:US
Mailing Address - Phone:949-636-5268
Mailing Address - Fax:949-916-4304
Practice Address - Street 1:26115 SALLY DR
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-5540
Practice Address - Country:US
Practice Address - Phone:949-916-4304
Practice Address - Fax:949-916-4304
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300187AP101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)