Individual provider · Type 1 NPI

Elisse Vassallo, FNP-BC

Family Nurse Practitioner · Marina Del Rey, CA

NPI number 1104490796 Active

Practice location

4676 Admiralty Way Ste 301
Marina Del Rey, CA 90292-6601

Call (310) 673-3945 Map

Mailing address

228 Via Los Miradores
Redondo Beach, CA 90277-6760

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X95017219 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1104490796

Elisse Vassallo, FNP-BC's National Provider Identifier is 1104490796, issued on May 18, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Marina Del Rey, CA. The record was last updated on Sep 29, 2022.