Provider Demographics
NPI:1740623487
Name:KNIPPEL, VANESSA LYNN (MA, LMFT 53937)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:LYNN
Last Name:KNIPPEL
Suffix:
Gender:F
Credentials:MA, LMFT 53937
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:LYNN
Other - Last Name:LEMMINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3978 SORRENTO VALLEY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1436
Mailing Address - Country:US
Mailing Address - Phone:858-847-8429
Mailing Address - Fax:
Practice Address - Street 1:1141 W MAIN AVE STE 201
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-1695
Practice Address - Country:US
Practice Address - Phone:920-338-1610
Practice Address - Fax:920-338-1616
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
WI1222-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist