Provider Demographics
NPI:1275329310
Name:KNIGHT, MAKAHLA
Entity type:Individual
Prefix:
First Name:MAKAHLA
Middle Name:
Last Name:KNIGHT
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 1:474 DOLORES AVE APT 209
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-5002
Mailing Address - Country:US
Mailing Address - Phone:510-612-9275
Mailing Address - Fax:
Practice Address - Street 1:474 DOLORES AVE APT 209
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-5002
Practice Address - Country:US
Practice Address - Phone:510-612-9275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst