Individual
MS. KELLY RAYE BORREGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT, CES
Contact information
Practice address
440 SAINT KATHERINE DR, LA CANADA FLINTRIDGE, CA 91011-4113
(626) 685-8356
(626) 685-8503
Mailing address
1496 N FAIRVALLEY AVE, COVINA, CA 91722-2031
(626) 488-7545
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000020886
CA
2255A2300X
Athletic Trainer
AT6364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699142216
ATHLETIC TRAINER
CA
Enumeration date
08/31/2015
Last updated
09/24/2018
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