Brenna Michelle Kelly

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

238 S Rampart Blvd
Los Angeles, CA 90057-1404

Phone

(626) 528-1886

NPI assigned

Oct 20, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1053910166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 W 220TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905014021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 S RAMPART BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571404",
            "telephone_number": "626-528-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRENNA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ho, D.D.S.
• Angel Rene Kelly-Blaydes, MSW
• Samantha Kelly-Latzer
• Alison Scott Kelly, M.S., R.D.
• Aubrey Derrick Kelly
• Carol Ann Kelly, ED.D.
• Christina Ann Kelly
• El'Lina Janay Kelly
• Emma Kelly
• Enda Kelly, MD

• Case Manager/Care Coordinator in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.