Individual
KELSEY JEPSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11100 WARNER AVE STE 368, FOUNTAIN VALLEY, CA 92708-7514
(714) 410-1025
Mailing address
8578 AMAZON RIVER CIR, FOUNTAIN VALLEY, CA 92708-5510
(818) 319-8192
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95021529
CA
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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