Individual
ANGELA DAWN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2410 E ST, SAN DIEGO, CA 92102-2024
(619) 234-3346
Mailing address
2410 E ST, SAN DIEGO, CA 92102-2024
(619) 234-3346
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1310450618
CCAPP
CA
Enumeration date
08/07/2018
Last updated
04/12/2021
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