LISA KELLLUM RN BSN PHN NPI 1629107586

NPI Information

  • NPI: 1629107586
  • Provider Name: LISA KELLLUM, RN BSN PHN
  • Classification: Registered Nurse - 163WC0400X
  • Specialization: Case Management
  • Entity Type: Individual
  • Address: 2440 GRAND AVE
    SAN DIEGO, CA
    ZIP 92109
  • Phone: (858) 490-4426

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NPI Details

Lisa Kelllum, RN BSN PHN is a case management registered nurse in San Diego, CA. Lisa Kelllum, RN BSN PHN NPI is 1629107586. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2440 GRAND AVE
SAN DIEGO, CA
ZIP 92109-858
Phone: (858) 490-4426

The enumeration date for this NPI number is 3/5/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WC0400XRegistered NurseCase ManagementRN469227CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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