Provider Demographics
NPI:1821087495
Name:WCISLO, KAREN LEIGH (MS, CGC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEIGH
Last Name:WCISLO
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:GENETICS DEPARTMENT, KAISER PERMANENTE
Mailing Address - Street 2:5755 COTTLE ROAD, BUILDING 1
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123
Mailing Address - Country:US
Mailing Address - Phone:408-972-3306
Mailing Address - Fax:408-972-3298
Practice Address - Street 1:GENETICS DEPARTMENT, KAISER PERMANENTE
Practice Address - Street 2:5755 COTTLE ROAD, BUILDING 1
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123
Practice Address - Country:US
Practice Address - Phone:408-972-3306
Practice Address - Fax:408-972-3298
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS