Provider Demographics
NPI:1104389873
Name:KNOTT, ELLEN SARAH (PT, DPT)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:SARAH
Last Name:KNOTT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13075 PACIFIC PROMENADE APT 105
Mailing Address - Street 2:
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2109
Mailing Address - Country:US
Mailing Address - Phone:818-631-4334
Mailing Address - Fax:
Practice Address - Street 1:13075 PACIFIC PROMENADE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90094-2110
Practice Address - Country:US
Practice Address - Phone:818-631-4334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT433112251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics