Provider Demographics
NPI:1598058802
Name:VAUGHN, TIMIKIA (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:TIMIKIA
Middle Name:
Last Name:VAUGHN
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 1:2731 WOODRIDGE MANOR DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-2753
Mailing Address - Country:US
Mailing Address - Phone:650-249-9090
Mailing Address - Fax:650-412-2305
Practice Address - Street 1:201 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-2396
Practice Address - Country:US
Practice Address - Phone:650-249-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS