Provider Demographics
NPI:1407399801
Name:BELLARDI, KERSTI
Entity type:Individual
Prefix:
First Name:KERSTI
Middle Name:
Last Name:BELLARDI
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 1:117 BAYSIDE PL
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2856
Mailing Address - Country:US
Mailing Address - Phone:949-423-8891
Mailing Address - Fax:
Practice Address - Street 1:2000 CANAL ST STE 2720
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3018
Practice Address - Country:US
Practice Address - Phone:504-702-2287
Practice Address - Fax:504-702-2500
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No172V00000XOther Service ProvidersCommunity Health Worker