Provider Demographics
NPI:1467617167
Name:BAILEY, ADRIENNE MICHELLE (MS, CGC)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MICHELLE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:MICHELLE
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:21 ALABASTER
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5477
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5300 MCCONNELL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-7026
Practice Address - Country:US
Practice Address - Phone:310-482-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2005237170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS