Provider Demographics
NPI:1932440567
Name:KORTY, LAUREN ANN (MS, CGC)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ANN
Last Name:KORTY
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ANN
Other - Last Name:DENNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:9300 CAMPUS POINT DR # MC7768
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1300
Mailing Address - Country:US
Mailing Address - Phone:858-657-7200
Mailing Address - Fax:858-249-5455
Practice Address - Street 1:9300 CAMPUS POINT DR
Practice Address - Street 2:MC 7768
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1300
Practice Address - Country:US
Practice Address - Phone:760-657-7206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000061170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS