Provider Demographics
NPI:1467269647
Name:SCHONLAND, KELLEY
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:SCHONLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2648 E WORKMAN AVE # 3001162
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1604
Mailing Address - Country:US
Mailing Address - Phone:626-374-9884
Mailing Address - Fax:626-374-9884
Practice Address - Street 1:629 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3511
Practice Address - Country:US
Practice Address - Phone:626-374-9884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88227225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist