Provider Demographics
NPI:1811166416
Name:TRIVEDI, AMBER PAKILIT (MS, CGC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:PAKILIT
Last Name:TRIVEDI
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 1:5624 SPANISH HORSE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-5543
Mailing Address - Country:US
Mailing Address - Phone:800-975-4819
Mailing Address - Fax:
Practice Address - Street 1:5624 SPANISH HORSE
Practice Address - Street 2:APT/SUITE
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-5543
Practice Address - Country:US
Practice Address - Phone:800-975-4819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL246.000035170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS