Basic Information
| Provider Information | |||||||||
| NPI: | 1851757322 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NELSON | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | ANGEL | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 839 | ||||||||
| Address2: | |||||||||
| City: | VALLEY CENTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607491410 | ||||||||
| FaxNumber: | 9514711453 | ||||||||
| Practice Location | |||||||||
| Address1: | 50100 GOLSH RD. | ||||||||
| Address2: | |||||||||
| City: | VALLEY CENTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607491410 | ||||||||
| FaxNumber: | 7607493347 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2016 | ||||||||
| LastUpdateDate: | 08/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CATC-I #7154-I | CA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 106H00000X | MFT INTERN. #90016 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | LMFT112967 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.