Provider Demographics
NPI:1043928773
Name:CLEEK, PAIGE (CGC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:CLEEK
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6323 OLD ORCHARD WAY
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-4145
Mailing Address - Country:US
Mailing Address - Phone:208-585-1199
Mailing Address - Fax:
Practice Address - Street 1:1111 EXPOSITION BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4324
Practice Address - Country:US
Practice Address - Phone:916-736-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC001677170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGC001677OtherDEPARTMENT OF PUBLIC HEALTH
20930OtherAMERICAN BOARD OF GENETIC COUNSELING