Kelli Destasio
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Mariposa, CA
NPI 1225754021 · NPPES record last updated Sep 1, 2026
Key facts
- NPI
- 1225754021
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 5362 Lemee LN
Mariposa, CA 95338-9556 - Phone
- (209) 966-2000
- NPI assigned
- Oct 13, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
5362 Lemee LN
Mariposa, CA 95338-9556
Mailing address
PO Box 99
Mariposa, CA 95338-0099
Other providers in Mariposa, CA
- Jett Davidson
- Todd Joshua Davidson
- Audrey Davis
- Philip Henry De Bry
- Lisbeth Ashley Dean
- Jeffrey L Dilbeck
- Christine L Doss
- Lorena Dowling
- Debbie J Drennon
- Stephanie Dumford
All providers in Mariposa, CA · Student in an Organized Health Care Education/Training Program in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.