Healthcare Provider Details

I. General information

NPI: 1306843990
Provider Name (Legal Business Name): DARRICK P. NELSON M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 PLACER ST
REDDING CA
96001-1125
US

IV. Provider business mailing address

1035 PLACER ST
REDDING CA
96001-1125
US

V. Phone/Fax

Practice location:
  • Phone: 530-921-6036
  • Fax: 530-921-6036
Mailing address:
  • Phone: 530-246-5710
  • Fax: 530-245-0863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2010-0242
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL5071
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number176634
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: