Individual provider · Type 1 NPI

Keely Larson

Student in an Organized Health Care Education/Training Program · San Diego, CA

NPI number 1043138092 Active

Practice location

16601 Night Hawk Ln
San Diego, CA 92127-4457

Call (858) 487-0877 Map

Mailing address

9055 Balboa Ave
San Diego, CA 92123-1509

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1043138092

Keely Larson's National Provider Identifier is 1043138092, issued on Jul 8, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in San Diego, CA. The record was last updated on Jul 8, 2026.