Provider Demographics
NPI:1982764726
Name:KNIGHT, KIMBERLY BROWN (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:BROWN
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
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Mailing Address - Street 1:1400 VETERANS BLVD
Mailing Address - Street 2:OUTPATIENT INTENSIVE EATING DISORDER PROGRAM
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2612
Mailing Address - Country:US
Mailing Address - Phone:650-299-2055
Mailing Address - Fax:650-299-4790
Practice Address - Street 1:1400 VETERANS BLVD
Practice Address - Street 2:OUTPATIENT INTENSIVE EATING DISORDER PROGRAM
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2612
Practice Address - Country:US
Practice Address - Phone:650-299-2055
Practice Address - Fax:650-299-4790
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA714893133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered