Healthcare Provider Details

I. General information

NPI: 1386622892
Provider Name (Legal Business Name): LAWRENCE PRENSKY M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 CALIFORNIA ST ROOM G310
SAN FRANCISCO CA
94118-1618
US

IV. Provider business mailing address

2211 VISTA DEL MAR
SAN MATEO CA
94404-2488
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-2153
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: