Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Elisse Vassallo, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1104490796

Elisse Vassallo, FNP-BC is a Nurse Practitioner in Marina del Rey, California. Qualified in 2014, 12 years ago. Practices with Cedars-Sinai Medical Care Foundation, a 1,696-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
12
Licensed in
CA
In the registry since
2021
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

4676 Admiralty Way Ste 301
Marina del Rey, CA 90292-6601
Phone: (310) 673-3945
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95017219 (CA)

Record details

NPI number1104490796
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedMay 18, 2021
Last updated in NPPESSeptember 29, 2022
Certification dateSeptember 29, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Cedars-Sinai Medical Care Foundation — 1696 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Marina del Rey