Provider Demographics
NPI:1649395591
Name:NELSON, DEBRA ANN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:NELSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:DEBBIE
Other - Middle Name:ANN
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:2116 ARLINGTON AVE.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018
Mailing Address - Country:US
Mailing Address - Phone:310-543-9900
Mailing Address - Fax:
Practice Address - Street 1:2116 ARLINGTON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-1336
Practice Address - Country:US
Practice Address - Phone:310-543-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 36617101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health