Individual
LINDA D NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., ABPN
Contact information
Practice address
35 S RAYMOND AVE, SUITE 304, PASADENA, CA 91105-1931
(626) 304-9960
(626) 304-9995
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 825-6429
(310) 206-5061
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY10688
CA
2084P0804X
Child & Adolescent Psychiatry Physician
PSY10688
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY106880
MEDICAL
CA
Enumeration date
06/09/2006
Last updated
04/30/2012
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