Provider Demographics
NPI:1326027285
Name:WENDT, KIMBERLY ANNE (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ANNE
Last Name:WENDT
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4580 ELECTRONICS PL
Mailing Address - Street 2:SCPMG GENETIC TESTING
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1008
Mailing Address - Country:US
Mailing Address - Phone:818-502-5959
Mailing Address - Fax:818-502-5921
Practice Address - Street 1:4580 ELECTRONICS PL
Practice Address - Street 2:SCPMG GENETIC TESTING
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1008
Practice Address - Country:US
Practice Address - Phone:818-502-5959
Practice Address - Fax:818-502-5921
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS