Provider Demographics
NPI:1578589628
Name:HERBERT, STEPHANIE KIRSTEN (MS)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KIRSTEN
Last Name:HERBERT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 FOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-4908
Mailing Address - Country:US
Mailing Address - Phone:617-869-0003
Mailing Address - Fax:
Practice Address - Street 1:212 SAN JOSE ST
Practice Address - Street 2:SUITE 311
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3928
Practice Address - Country:US
Practice Address - Phone:831-759-3269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS