Individual
MRS. KELLY LYNN BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
828 W VENTURA ST STE 100, FILLMORE, CA 93015-1877
(805) 524-2000
Mailing address
4484 COFFEETREE LN, MOORPARK, CA 93021-3533
(805) 529-2225
(805) 529-2225
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
20091
CA
Other
Enumeration date
01/13/2009
Last updated
12/03/2021
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