Individual
BRIDGET KELLEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
604 ROSE AVE, VENICE, CA 90291-2767
(310) 392-8636
Mailing address
604 ROSE AVE, VENICE, CA 90291-2767
(310) 392-8636
(310) 392-6642
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95003447
CA
Other
Enumeration date
12/22/2015
Last updated
11/01/2018
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