Nelson Brown Jr.

Individual provider Active NPI Health Educator · Highland, CA

NPI 1104223049 · NPPES record last updated Aug 18, 2016

Key facts

NPI
1104223049
Entity type
Individual (NPI type 1)
Primary specialty
Health Educator 174H00000X
Practice address
7231 Boulder Ave
Suite 293
Highland, CA 92346-3313
Phone
(909) 910-8200
NPI assigned
Nov 20, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
46246CAMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 46246 CA
Health Educator 174H00000X Yes
Nutrition Education Nutritionist 133NN1002X
Massage Therapist 225700000X

Addresses

Primary practice location

7231 Boulder Ave
Suite 293
Highland, CA 92346-3313

Mailing address

7231 Boulder Ave
Suite 293
Highland, CA 92346-3313
Phone (909) 910-8200

Other providers in Highland, CA

All providers in Highland, CA · Health Educator in California

Sources for this page

Verify at the official NPI Registry.