Individual
KELLY JEANNETTE SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(323) 715-4965
Mailing address
1031 W 78TH ST, LOS ANGELES, CA 90044-3501
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
01/23/2017
Last updated
05/13/2025
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