Individual
MR. KEVIN MICHAEL VELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1983 MARENGO ST, LOS ANGELES, CA 90033-1370
(323) 409-7985
Mailing address
4378 YELLOWSTONE ST, LOS ANGELES, CA 90032-3743
(626) 498-5353
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95021276
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/12/2021
Last updated
10/19/2022
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