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Individual
KELLIE MORALES
Active
Individual
KELLIE MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPAS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61013
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA61013
PHYSICIAN ASSISTANT BOARD
CA
Enumeration date
06/29/2021
Last updated
03/07/2023
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