Provider Demographics
NPI:1174958557
Name:MASH, JANINE MARIE GESSNER (LCGC)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:MARIE GESSNER
Last Name:MASH
Suffix:
Gender:F
Credentials:LCGC
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:MARIE
Other - Last Name:GESSNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:278 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-4805
Mailing Address - Country:US
Mailing Address - Phone:303-501-3361
Mailing Address - Fax:
Practice Address - Street 1:2356 SUTTER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3006
Practice Address - Country:US
Practice Address - Phone:415-353-1397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS