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General NPI Number Information
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NPI Number | 1821499963
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Entity Type | Organization
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Legal Business Name | LUCILE PACKARD CHILDREN'S HOSPITAL STANFORD
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 09/09/2014
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Provider Practice Location Address
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Address Line | 725 WELCH RD # MC5652
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City | PALO ALTO
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State | CA
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Zip | 94304-1601
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Country | US
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Telephone | 650-721-1145
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Fax | 650-725-2878
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Provider Business Mailing Address
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Address Line | 725 WELCH RD # MC5652
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City | PALO ALTO
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State | CA
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Zip | 94304-1601
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Country | US
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Telephone | 650-721-1145
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Fax | 650-725-2878
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Authorized Official
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Title or Position | GENETIC COUNSELING SUPERVISOR
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Name | MS. JOANNE TAYLOR
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Credential | MS CGC LGC
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Telephone | 650-723-9865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QG0250X
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Taxonomy Name | Genetics Clinic/Center
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License Number | GC000572
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License Number State | CA
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