Provider Demographics
NPI:1043584055
Name:SEGAL, SUMMER (MS, LGC)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:SEGAL
Suffix:
Gender:F
Credentials:MS, LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 PARNASSUS AVE
Mailing Address - Street 2:CAMPUS BOX 0748
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2208
Mailing Address - Country:US
Mailing Address - Phone:415-476-4674
Mailing Address - Fax:415-476-9976
Practice Address - Street 1:533 PARNASSUS AVE
Practice Address - Street 2:CAMPUS BOX 0748
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2208
Practice Address - Country:US
Practice Address - Phone:415-476-4674
Practice Address - Fax:415-476-9976
Is Sole Proprietor?:No
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000346170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS