Provider Demographics
NPI:1902935315
Name:BURKE, STEPHANIE W (MS)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:W
Last Name:BURKE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:WINTERS
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CLGC
Mailing Address - Street 1:300 PASTEUR DR # H-315
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-5198
Mailing Address - Fax:650-725-2878
Practice Address - Street 1:2147 MOWRY AVE STE C6
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1724
Practice Address - Country:US
Practice Address - Phone:510-713-9994
Practice Address - Fax:510-713-9997
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000303170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS