Provider Demographics
NPI:1730303405
Name:REISIGER, KIMBERLY JOANNE (MS, CGC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JOANNE
Last Name:REISIGER
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:JOANNE
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:2350 W EL CAMINO REAL
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-6201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2485 HOSPITAL DR
Practice Address - Street 2:SUITE 231
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4101
Practice Address - Country:US
Practice Address - Phone:650-404-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2005103170300000X
CAGC000207170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS