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General NPI Number Information
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NPI Number | 1003401001
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Entity Type | Individual
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Provider Name | BAILEY MICHELLE SANDERSON MSGC, LCGC
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Gender | Female
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 1625 STOCKTON BLVD STE 112
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City | SACRAMENTO
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State | CA
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Zip | 95816-7098
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Country | US
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Telephone | 916-887-4827
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Fax | 916-887-4834
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Provider Business Mailing Address
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Address Line | 700 SAN ANTONIO WAY
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City | SACRAMENTO
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State | CA
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Zip | 95819-2716
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Country | US
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Telephone | 815-739-5060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | GC001240
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License Number State | CA
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