Individual
REUBEN RANDALL NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11482 LOMA LINDA DR, LOMA LINDA, CA 92354-3743
(909) 723-7877
Mailing address
3286 E GUASTI RD STE 100, ONTARIO, CA 91761-8646
(909) 476-2023
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
369324
CA
Other
Enumeration date
02/29/2024
Last updated
02/29/2024
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