Provider Demographics
NPI:1124019153
Name:CHEN, KELLY MAY (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:MAY
Last Name:CHEN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STANFORD HOSPITAL, DEPT PEDIATRICS, DIVISION GENETICS
Mailing Address - Street 2:300 PASTEUR DRIVE, ROOM H-315
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5208
Mailing Address - Country:US
Mailing Address - Phone:650-725-6628
Mailing Address - Fax:650-724-1394
Practice Address - Street 1:STANFORD HOSPITAL, DEPT PEDIATRICS, DIVISION GENETICS
Practice Address - Street 2:300 PASTEUR DRIVE, ROOM H-315
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5208
Practice Address - Country:US
Practice Address - Phone:650-725-6628
Practice Address - Fax:650-724-1394
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS