Individual
JESSICA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
5511 SURFRIDER WAY, SAN DIEGO, CA 92154-8602
(678) 551-3586
Mailing address
5511 SURFRIDER WAY, SAN DIEGO, CA 92154-8602
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN262622
CA
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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