Provider Demographics
NPI:1841275542
Name:ORNELAS KNIGHT, MICHELE MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:MARIE
Last Name:ORNELAS KNIGHT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MICHELE
Other - Middle Name:MARIE ORNELAS
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:3671 BUSINESS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-2165
Mailing Address - Country:US
Mailing Address - Phone:916-734-6618
Mailing Address - Fax:916-734-4150
Practice Address - Street 1:3671 BUSINESS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-2165
Practice Address - Country:US
Practice Address - Phone:916-734-6618
Practice Address - Fax:916-734-4150
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17738103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical