Provider Demographics
NPI:1447863410
Name:KNIGHT, PATRICK SAMUEL
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:SAMUEL
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16057 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-5734
Mailing Address - Country:US
Mailing Address - Phone:818-452-8602
Mailing Address - Fax:818-762-7643
Practice Address - Street 1:6350 LAUREL CANYON BLVD STE 307
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3223
Practice Address - Country:US
Practice Address - Phone:818-762-7643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist