Provider Demographics
NPI:1659342517
Name:VANCE, AMY CARYN (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:CARYN
Last Name:VANCE
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 1:32 TERRACE AVE
Mailing Address - Street 2:BAY AREA GENETIC COUNSELING
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-2427
Mailing Address - Country:US
Mailing Address - Phone:415-453-4384
Mailing Address - Fax:
Practice Address - Street 1:32 TERRACE AVE
Practice Address - Street 2:BAY AREA GENETIC COUNSELING
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-2427
Practice Address - Country:US
Practice Address - Phone:415-453-4384
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANONE170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS