Individual
AUSTIN DEAN NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 HIGUERA ST UNIT 33B, SAN LUIS OBISPO, CA 93401-4195
(530) 212-0288
Mailing address
550 HIGUERA ST UNIT 33B, SAN LUIS OBISPO, CA 93401-4195
(530) 212-0288
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
109696
CA
1041C0700X
Clinical Social Worker
91313
CA
Other
Enumeration date
08/14/2019
Last updated
05/28/2023
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