| Gina Nelson | |
|
555 Oakdale St Ste D Folsom CA 95630-2451 | |
| (916) 496-7663 | |
| Not Available |
| Full Name | Gina Nelson |
|---|---|
| Speciality | Social Worker |
| Location | 555 Oakdale St Ste D, Folsom, California |
| Authorized Official Name and Position | Gina Nelson (PROVIDER) |
| Authorized Official Contact | 9164967663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gina Nelson 555 Oakdale St Ste D Folsom CA 95630-2451 Ph: (916) 496-7663 | Gina Nelson 555 Oakdale St Ste D Folsom CA 95630-2451 Ph: (916) 496-7663 |
| NPI Number | 1124686605 |
|---|---|
| Provider Enumeration Date | 05/30/2019 |
| Last Update Date | 05/30/2019 |
| Medicare PECOS PAC ID | 0244649036 |
|---|---|
| Medicare Enrollment ID | O20210909001565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124686605 | NPI | - | NPPES |
| LCS19822 | Other | CA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Gina E Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992217277 PECOS PAC ID: 3870852411 Enrollment ID: I20210909001713 |
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