Provider Demographics
NPI:1124457767
Name:KNOWLES, MARINA
Entity type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-3424
Mailing Address - Country:US
Mailing Address - Phone:510-269-9030
Mailing Address - Fax:
Practice Address - Street 1:18200 HIGHWAY 178
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-9510
Practice Address - Country:US
Practice Address - Phone:661-871-9697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health