Doctor Name: | MRS. CYNTHIA KAE NELSON |
NPI Number: | 1700099090 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MASTER'S |
License Number: | |
Business Practice Address: | 767 Ramona Ave Grover Beach, CA - 93433 |
Business Phone Number: | 8053499600 |
Business Fax Number: | |
Mailing Address: | 767 Ramona Ave, GROVER BEACH |
State: | CA |
Postal Code: | 93433 |
Phone Number: | 8053499600 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2007 |
NPI Last Update Date: | 10/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |