Provider Demographics
NPI:1184929358
Name:NELSON, PATRICIA LYNNE (CADC-CAS)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYNNE
Last Name:NELSON
Suffix:
Gender:F
Credentials:CADC-CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 NOTRE DAME CT
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-1831
Mailing Address - Country:US
Mailing Address - Phone:707-655-3434
Mailing Address - Fax:
Practice Address - Street 1:627 GRANT ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-7228
Practice Address - Country:US
Practice Address - Phone:707-553-1042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)