Provider Demographics
NPI:1396734968
Name:EL-KHECHEN, DIMA (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:DIMA
Middle Name:
Last Name:EL-KHECHEN
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 1:15 ARGONAUT
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1423
Mailing Address - Country:US
Mailing Address - Phone:949-900-5531
Mailing Address - Fax:949-900-5554
Practice Address - Street 1:15 ARGONAUT
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-1423
Practice Address - Country:US
Practice Address - Phone:949-900-5531
Practice Address - Fax:949-900-5554
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS