Individual
DIANE NEILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4455 MORENA BLVD STE 102, SAN DIEGO, CA 92117-4329
(571) 276-0170
Mailing address
325 S SIERRA AVE UNIT 23, SOLANA BEACH, CA 92075-2222
(571) 276-0170
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6590
CA
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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