Sandra Lee Knickerbocker, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

108057 Issued in CA

Practice address

2816 Adams Ave
San Diego, CA 92116-1401

Phone

(619) 937-1900

NPI assigned

Oct 17, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Seeking Sanctuary

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1760179030
  Authorized official Same address or phone

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1730690728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 MISSION GORGE RD SPC 86",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920713580",
            "telephone_number": "619-937-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 ADAMS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161401",
            "telephone_number": "619-937-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "108057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3704",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darshana Kneebone
• Jamie Caroline Kneebusch, PHARM.D.
• Stacey Marie Kneeshaw, LPCC
• David Knepp
• Rachel Knerr
• Nancy Kniffin-Jennings
• Knight Osteopathic Healing Inc
• Aimee Anselm Knight, MD
• Alicia Knight, LMFT
• Allison Knight

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.