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NPI Code Detail

MEDICARE: KEILANI VELASCO

MEDICARE: KEILANI VELASCO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174H00000XHealth Educator
2390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1548007412
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEILANI VELASCO
Provider Business Mailing Address
First Line : 6160 MISSION GORGE RD STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-3425
Country : US
Telephone Number : 619-481-3790
Fax Number : 619-481-3797
Provider Business Practice Location Address
First Line : 6160 MISSION GORGE RD STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-3425
Country : US
Telephone Number : 619-481-3790
Fax Number : 619-481-3797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2024
Last Update Date : 05/26/2026

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Directions to “ KEILANI VELASCO ” Practice Location

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