Provider Demographics
NPI:1447627880
Name:VICTORINE, ANNA SPENCER (MS, CGC)
Entity type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:SPENCER
Last Name:VICTORINE
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 1:9449 IMPERIAL HWY
Mailing Address - Street 2:SUITE 432 , GENETICS
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242
Mailing Address - Country:US
Mailing Address - Phone:562-657-4842
Mailing Address - Fax:562-657-4408
Practice Address - Street 1:9449 IMPERIAL HWY
Practice Address - Street 2:SUITE 432 , GENETICS
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242
Practice Address - Country:US
Practice Address - Phone:562-657-4842
Practice Address - Fax:562-657-4408
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
CAGC001078170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS