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General NPI Number Information
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NPI Number | 1336371582
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Entity Type | Individual
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Provider Name | ROSALYNN NELSON MD
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Gender | Female
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | ONE WASHINGTON SQUARE
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City | SAN JOSE
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State | CA
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Zip | 95192
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Country | US
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Telephone | 408-924-6122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 58484
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City | HOUSTON
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State | TX
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Zip | 77258-8484
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Country | US
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Telephone | 832-385-1909
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A118707
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | P4121
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License Number State | TX
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