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Individual

BRYAN SANG HYUK NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
500 12TH ST STE 110, OAKLAND, CA 94607-4005
(612) 501-6299
Mailing address
PO BOX 19961, PORTLAND, OR 97280-0961
(612) 501-6299

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Y835265289516
103TC0700X
Clinical Psychologist
Primary
28848
CA

Other

Enumeration date
07/25/2012
Last updated
07/31/2024
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