Provider Demographics
NPI:1740830173
Name:NELSON, CHRISTOPHER TOBY (REGISTERED CAODC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:TOBY
Last Name:NELSON
Suffix:
Gender:M
Credentials:REGISTERED CAODC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23641 NEWHALL AVE APT 314
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-4621
Mailing Address - Country:US
Mailing Address - Phone:541-390-1019
Mailing Address - Fax:
Practice Address - Street 1:221 E WALNUT ST STE 120
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1554
Practice Address - Country:US
Practice Address - Phone:626-802-8287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)