Individual provider Active NPI

Taiann Catherine Knetge

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1205319688
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104395 Issued in CA
Practice address
3151 Cahuenga Blvd W # Stw335
Los Angeles, CA 90068-1768
Phone
(626) 354-8682
NPI assigned
Sep 11, 2018
Last updated
Dec 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 104395 CA Primary
Clinical Social Worker 1041C0700X ASW85040 CA

Addresses

Primary practice location

3151 Cahuenga Blvd W # Stw335
Los Angeles, CA 90068-1768

Mailing address

3151 Cahuenga Blvd W # Stw335
Los Angeles, CA 90068-1768
Phone (626) 354-8682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW85040CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1205319688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 CAHUENGA BLVD W # STW335",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900681768",
            "telephone_number": "626-354-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 CAHUENGA BLVD W # STW335",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900681768",
            "telephone_number": "626-354-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNETGE",
        "first_name": "TAIANN",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "104395",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW85040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.