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NPI Code Detail

MEDICARE: LEAH MARIE NELSON

MEDICARE: LEAH MARIE 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
11041C0700XClinical Social Worker99233CA

General Provider Information

NPI Number : 1962722405
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH MARIE NELSON
Provider Business Mailing Address
First Line : PO BOX 235945
Second Line :
City : ENCINITAS
State : CA
Zip : 92023-5945
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 MISSION AVE STE 110
Second Line :
City : OCEANSIDE
State : CA
Zip : 92058-7110
Country : US
Telephone Number : 858-351-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2010
Last Update Date : 10/15/2025

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Directions to “ LEAH MARIE NELSON ” Practice Location

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