Provider Demographics
NPI:1982367611
Name:DEFELICE, CHELSEA (NP)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:DEFELICE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:STAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:8415 LAKE BACA DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-3145
Mailing Address - Country:US
Mailing Address - Phone:858-761-2933
Mailing Address - Fax:
Practice Address - Street 1:8010 FROST ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2778
Practice Address - Country:US
Practice Address - Phone:858-939-8350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018858363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty