Provider Demographics
NPI:1962287342
Name:RUNA, SAMANTHA (GC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:RUNA
Suffix:
Gender:F
Credentials:GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2931
Mailing Address - Country:US
Mailing Address - Phone:562-754-3273
Mailing Address - Fax:
Practice Address - Street 1:2825 50TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2310
Practice Address - Country:US
Practice Address - Phone:916-703-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC001754170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS