Provider Demographics
NPI:1558852244
Name:KNAPP, RYAN MICHAEL
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:MICHAEL
Last Name:KNAPP
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 1:665 CORDOVA ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2530
Mailing Address - Country:US
Mailing Address - Phone:562-322-1842
Mailing Address - Fax:
Practice Address - Street 1:225 GRANDVIEW ST APT 1
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2114
Practice Address - Country:US
Practice Address - Phone:626-689-4858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147231106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist