Individual
KELSEY STANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 MEDICAL PLAZA # B200, LOS ANGELES, CA 90095
(310) 794-1195
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95138010
CA
363L00000X
Nurse Practitioner
95007127
CA
363LA2200X
Adult Health Nurse Practitioner
Primary
95007127
CA
363LG0600X
Gerontology Nurse Practitioner
95007127
CA
Other
Enumeration date
06/12/2014
Last updated
01/14/2020
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