Kynoosh Seraji, MS, CGC

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

GC001771 Issued in CA

Practice address

7202 N Millbrook Ave Ste 209
Fresno, CA 93720-3341

Phone

(559) 450-5519

NPI assigned

Apr 13, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Katie Seraji Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saint Agnes Medical Foundation

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1558819482
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1952043440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E SPRUCE AVE STE 431",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203330",
            "telephone_number": "559-450-7449",
            "fax_number": "559-450-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7202 N MILLBROOK AVE STE 209",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203341",
            "telephone_number": "559-450-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERAJI",
        "first_name": "KYNOOSH",
        "credential": "MS, CGC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "MT",
            "license": "GEN-GEN-LIC-000471",
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "CA",
            "license": "GC001771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "SERAJI",
            "credential": "MS, CGC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Genetic Counselor (M.S.) in Fresno, CA
• Providers in Fresno, CA by specialty
• Genetic Counselor (M.S.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.