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General NPI Number Information
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NPI Number | 1013337906
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Entity Type | Individual
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Provider Name | KELSEY HAUNANI BAINS ATC, CPM, LM
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Gender | Female
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Dates
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Enumeration Date | 04/18/2014
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 30270 RANCHO VIEJO RD STE F
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1556
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Country | US
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Telephone | 818-422-8842
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Fax |
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Provider Business Mailing Address
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Address Line | 8045 E CHAPMAN AVE
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City | ORANGE
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State | CA
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Zip | 92869-4512
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Country | US
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Telephone | 714-628-4704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 030702110
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 769
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License Number State | CA
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