MEDICARE: JENNA WARDROP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)	GC000529	CA

General Provider Information

NPI Number	:	1235551441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA WARDROP

Provider Business Mailing Address
First Line	:	3595 JOHN HOPKINS CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1121
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3595 JOHN HOPKINS CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1121
Country	:	US
Telephone Number	:	858-242-1824
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2014
Last Update Date	:	01/08/2014

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Directions to “ JENNA WARDROP ” Practice Location

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