Pamela Nelson
Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Stevinson, CA
NPI 1124402227 · NPPES record last updated Jul 17, 2015
Key facts
- NPI
- 1124402227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Registered Nurse 163WP0808X
- License
- 397665 (CA)
- Practice address
- 19709 First Ave
Stevinson, CA 95374-9614 - Phone
- (209) 345-9659
- NPI assigned
- Jul 17, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 397665 | CA | MD | Psychiatric/Mental Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 397665 | CA | Yes |
Addresses
Primary practice location
19709 First Ave
Stevinson, CA 95374-9614
Mailing address
19709 First Ave
Stevinson, CA 95374-9614
Phone (209) 345-9659
Other providers in Stevinson, CA
All providers in Stevinson, CA · Psychiatric/Mental Health Registered Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.