Individual
DR. ROBERT C NELSON
Active
Individual
DR. ROBERT C NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1210
SC
2084P0800X
Psychiatry Physician
RPS2002005
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301100
—
SC
01
—
P01126706
RR MEDICARE
SC
05
—
PS0511
—
SC
Enumeration date
10/04/2006
Last updated
09/22/2013
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