Individual
KEVIN SAN LUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
11900 AVALON BLVD STE 100, LOS ANGELES, CA 90061-2867
(888) 783-1883
Mailing address
11900 AVALON BLVD STE 100, LOS ANGELES, CA 90061-2867
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2024026806
CA
Other
Enumeration date
06/18/2024
Last updated
01/27/2025
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