SANDRA LEE KNICKERBOCKER LMFT - NPI 1730690728 - Marriage & Family Therapist in San Diego, CA

Q: What is Sandra Knickerbocker's NPI number?

The NPI number for Sandra Knickerbocker is 1730690728. It was assigned to this individual provider in the NPPES registry on October 17, 2017.

Q: What is Sandra Knickerbocker's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

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About Sandra Lee Knickerbocker Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANDRA LEE KNICKERBOCKER LMFT (NPI 1730690728) is an individual marriage & family therapist in San Diego, California, licensed in California (108057) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730690728

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameSANDRA LEE KNICKERBOCKERCredential: LMFT

Location Address2816 ADAMS AVESan Diego, CA 92116-1401

Mailing Address8301 Mission Gorge Rd Spc 86Santee, CA 92071-3580 · (619) 937-1900

Phone(619) 937-1900

Sole ProprietorYes

Enumeration DateOctober 17, 2017

Last NPPES UpdateMarch 12, 20202 updates tracked since enumeration

NPPES CertifiedMarch 12, 2020

✔ NPI 1730690728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 108057

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

2816 ADAMS AVE, San Diego, CA 92116

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Other Identifiers 1

Medicaid3704CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sandra Lee Knickerbocker Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRYAN HAYDEN DOVER MFT

Marriage & Family Therapist