MEDICARE: RACHEL NELSON M.S.

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
1	235Z00000X	Speech-Language Pathologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11725	OTHER	CA	SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY AND HEARING AID DISPENSERS BOARD

General Provider Information

NPI Number	:	1942728225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL NELSON M.S.

Provider Business Mailing Address
First Line	:	3031 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-1013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2826 W AVENUE 33
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-2120
Country	:	US
Telephone Number	:	972-310-1537
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2017
Last Update Date	:	09/06/2017

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Directions to “ RACHEL NELSON M.S.” Practice Location

Language	Start Address	Practice Location

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