Individual
KELLY GRAMILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
149 S MEDNIK AVE # 201, LOS ANGELES, CA 90022-1606
(626) 423-2973
Mailing address
149 S MEDNIK AVE # 201, LOS ANGELES, CA 90022-1606
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
04/27/2021
Last updated
04/30/2025
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