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NPI Code Detail

MEDICARE: ERIC WAYNE NELSON

MEDICARE: ERIC WAYNE 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
1251B00000XCase Management AgencyCA

General Provider Information

NPI Number : 1871450791
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC WAYNE NELSON
Provider Business Mailing Address
First Line : 7200 BANCROFT AVE STE 133
Second Line :
City : OAKLAND
State : CA
Zip : 94605-2480
Country : US
Telephone Number : 510-553-8500
Fax Number : 510-553-8550
Provider Business Practice Location Address
First Line : 7200 BANCROFT AVE STE 133
Second Line :
City : OAKLAND
State : CA
Zip : 94605-2480
Country : US
Telephone Number : 510-553-8500
Fax Number : 510-553-8550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ ERIC WAYNE NELSON ” Practice Location

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