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NPI Code Detail

MEDICARE: TALIA SADELL KELLY

MEDICARE: TALIA SADELL KELLY
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
11041C0700XClinical Social WorkerCA
2390200000XStudent in an Organized Health Care Education/Training Program
3171M00000XCase Manager/Care Coordinator
4225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1447085485
Entity Type Code : Individual
Provider Name (Legal Business Name) : TALIA SADELL KELLY
Provider Business Mailing Address
First Line : 5465 WEST BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-2429
Country : US
Telephone Number : 310-745-0005
Fax Number :
Provider Business Practice Location Address
First Line : 5603 S CENTRAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-5967
Country : US
Telephone Number : 323-432-3700
Fax Number : 323-432-3702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2024
Last Update Date : 06/18/2026

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