Sydney Dodge McIlvain, LCGC

Primary specialty

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

License

GC001804 Issued in CA

Practice address

3818 Surfwood Rd
Malibu, CA 90265-5657

Phone

(561) 601-7745

NPI assigned

Jul 10, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1982441697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3818 SURFWOOD RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902655657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3818 SURFWOOD RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902655657",
            "telephone_number": "561-601-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILVAIN",
        "first_name": "SYDNEY",
        "middle_name": "DODGE",
        "credential": "LCGC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "CA",
            "license": "GC001804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney McCaul, PSY. D.
• Lisa McCullough, LMFT
• Patricia McDermott, M.D.
• Kiley Ann McGill
• Andrea McGovern, MS MFT
• Kellye D McKinna, PHD
• Patricia Lee McNamee, PHARM.D.
• Mermaids Cove Malibu Inc.
• Leila Mesghali, LMFT
• Talin Meshefedjian, DO

• Genetic Counselor (M.S.) in Malibu, CA
• Providers in Malibu, 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 Jul 10, 2024; 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.