Individual provider Active NPI

Julian Tellez Knighton Jr.

  • Rehabilitation Practitioner
  • Los Angeles, CA
National Provider Identifier
1821671009
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
4401 Crenshaw Blvd Ste 215
Los Angeles, CA 90043-1200
Phone
(323) 291-7100
NPI assigned
May 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary
Behavior Analyst 103K00000X
Assistant Behavior Analyst 106E00000X

Addresses

Primary practice location

4401 Crenshaw Blvd Ste 215
Los Angeles, CA 90043-1200

Mailing address

3870 Crenshaw Blvd Ste 212
Los Angeles, CA 90008-1815
Phone (323) 290-5058

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

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1821671009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3870 CRENSHAW BLVD STE 212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081815",
            "telephone_number": "323-290-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CRENSHAW BLVD STE 215",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900431200",
            "telephone_number": "323-291-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHTON",
        "first_name": "JULIAN",
        "middle_name": "TELLEZ",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-04",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "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 Apr 5, 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.