Healthcare Provider Details

I. General information

NPI: 1689597072
Provider Name (Legal Business Name): CHELSI RAE OSBORN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHELSI JETT FNP

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 E PLYMOUTH ST
LONG BEACH CA
90805-5916
US

IV. Provider business mailing address

326 E PLYMOUTH ST
LONG BEACH CA
90805-5916
US

V. Phone/Fax

Practice location:
  • Phone: 510-925-3103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039962
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: