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NPI Code Detail

MEDICARE: KATIE NICOLE NELSON LMFT

MEDICARE: KATIE NICOLE NELSON LMFT
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
1106H00000XMarriage & Family Therapist135115CA

General Provider Information

NPI Number : 1992169551
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE NICOLE NELSON LMFT
Provider Business Mailing Address
First Line : 222 S HARBOR BLVD STE 650
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-3756
Country : US
Telephone Number : 714-847-5646
Fax Number :
Provider Business Practice Location Address
First Line : 222 S HARBOR BLVD STE 650
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-3756
Country : US
Telephone Number : 714-847-5646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2016
Last Update Date : 08/20/2024

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Directions to “ KATIE NICOLE NELSON LMFT” Practice Location

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