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NPI Code Detail

MEDICARE: SANII NELSON

MEDICARE: SANII NELSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1477672400
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANII NELSON
Provider Business Mailing Address
First Line : 312 MARIN ST
Second Line :
City : VALLEJO
State : CA
Zip : 94590-6037
Country : US
Telephone Number : 510-860-5334
Fax Number :
Provider Business Practice Location Address
First Line : 2495 W MARCH LN STE 125
Second Line :
City : STOCKTON
State : CA
Zip : 95207-8224
Country : US
Telephone Number : 510-200-4409
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 03/28/2017

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Directions to “ SANII NELSON ” Practice Location

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