Most Relevant Information
Provider Data
| NPI Number: | 1003183088 |
| Provider Name: | WALTER WILLIAM NIELSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | IMF78099 |
Most Important Dates
| Enumeration Date: | 11/19/2011 |
| Last Updated: | 05/19/2023 |
Provider Practice Location
1234 EMPIRE ST
FAIRFIELD
CA
945335711
Practice Location Phone/Fax
| Phone: | 7074397830 |
| Fax: |
Provider Mailing Location
4425 TROPAZ LN
TRACY
CA
953778411
Provider Mailing Phone/Fax
| Phone: | 1925961786 |
| Fax: |