Provider Demographics
NPI:1235940727
Name:CHILLINSKY, JORDAN (LCGC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:CHILLINSKY
Suffix:
Gender:F
Credentials:LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9756 MIKETO WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-6247
Mailing Address - Country:US
Mailing Address - Phone:415-967-3375
Mailing Address - Fax:
Practice Address - Street 1:1612 FILAREE CT
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-5020
Practice Address - Country:US
Practice Address - Phone:760-889-3698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC001910170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS