| Doctor Name: | MS. DANIELLE LYN KELLY |
| NPI Number: | 1053716233 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, CPNP |
| License Number: | 95001158 |
| Business Practice Address: | 1 Hope Dr Tustin, CA - 927820221 |
| Business Phone Number: | 7142470300 |
| Business Fax Number: | |
| Mailing Address: | 4721 W 153rd St, LAWNDALE |
| State: | CA |
| Postal Code: | 902601924 |
| Phone Number: | 4104590994 |
| Fax Number: | |
| NPI Enumeration Date: | 10/30/2014 |
| NPI Last Update Date: | 10/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 95001158 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |