Individual
JESSICA SARAH VIOLETTE KIANMAHD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCGC
Contact information
Practice address
200 MEDICAL PLAZA SUITE 265, LOS ANGELES, CA 90095-0001
(310) 206-6581
(310) 206-8616
Mailing address
10833 LE CONTE AVE # 12-334, LOS ANGELES, CA 90095-3075
(310) 206-6581
(310) 206-8616
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
GC000907
CA
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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