Individual
SHELLY ELISE BRENTZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12301 WILSHIRE BLVD STE 512, LOS ANGELES, CA 90025-1053
(888) 684-2779
Mailing address
7129 SALERNO ST, SAN DIEGO, CA 92111-3413
(410) 353-1447
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95132333
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95026831
CA
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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