Individual
ELISSE VASSALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4676 ADMIRALTY WAY STE 301, MARINA DEL REY, CA 90292-6601
(310) 673-3945
Mailing address
228 VIA LOS MIRADORES, REDONDO BEACH, CA 90277-6760
(908) 892-0781
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95017219
CA
Other
Enumeration date
05/18/2021
Last updated
09/29/2022
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