Provider Demographics
NPI:1659651024
Name:KNIGHT, MICHELLE ANGELA (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ANGELA
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9808 VENICE BOULEVARD
Mailing Address - Street 2:SUITE #700
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232
Mailing Address - Country:US
Mailing Address - Phone:310-945-3350
Mailing Address - Fax:310-945-3556
Practice Address - Street 1:9808 VENICE BOULEVARD
Practice Address - Street 2:SUITE #700
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232
Practice Address - Country:US
Practice Address - Phone:310-945-3350
Practice Address - Fax:310-945-3556
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95149287163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health