Individual
MARYPAT KELLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
80 GREAT OAKS BLVD, SAN JOSE, CA 95119-1310
(408) 363-3000
(408) 363-3082
Mailing address
1150 PINE ST, MENLO PARK, CA 94025-3455
(650) 473-0529
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
15112
CA
Other
Enumeration date
03/16/2006
Last updated
07/08/2007
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