Doctor Name: | JENNIFER LOUISE NELSON |
NPI Number: | 1710388079 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | |
Business Practice Address: | 7000b S Center Dr Clearlake, CA - 954228131 |
Business Phone Number: | 7079947090 |
Business Fax Number: | |
Mailing Address: | 6135 Ridgeview Dr, CLEARLAKE |
State: | CA |
Postal Code: | 954229434 |
Phone Number: | 7074831394 |
Fax Number: | |
NPI Enumeration Date: | 09/05/2014 |
NPI Last Update Date: | 12/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |