Provider Demographics
NPI:1134574031
Name:NELSON, RHONDA NICHELLE (PT, DPT, PCS)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:NICHELLE
Last Name:NELSON
Suffix:
Gender:F
Credentials:PT, DPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10431 COMMERCE ST STE A
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-0110
Mailing Address - Country:US
Mailing Address - Phone:909-735-7654
Mailing Address - Fax:
Practice Address - Street 1:10431 COMMERCE ST STE A
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-0110
Practice Address - Country:US
Practice Address - Phone:909-735-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA226642251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics