Provider Demographics
NPI:1083159511
Name:DUNN, KYLA (MS, LCGC)
Entity Type:Individual
Prefix:MS
First Name:KYLA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WELCH RD STE 305
Mailing Address - Street 2:STANFORD CHILDREN'S HEALTH-PEDIATRIC CARDIOLOGY
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1510
Mailing Address - Country:US
Mailing Address - Phone:650-736-8767
Mailing Address - Fax:650-724-4922
Practice Address - Street 1:725 WELCH RD
Practice Address - Street 2:LUCILE PACKARD CHILDREN'S HOSPITAL
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1601
Practice Address - Country:US
Practice Address - Phone:650-721-2121
Practice Address - Fax:650-497-8422
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000329170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS