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NPI Code Detail

MEDICARE: CHRISTINE COLLATOS

MEDICARE: CHRISTINE COLLATOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-20-43266CA

General Provider Information

NPI Number : 1538616404
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE COLLATOS
Provider Business Mailing Address
First Line : 1481 VILLAGE VIEW RD
Second Line :
City : ENCINITAS
State : CA
Zip : 92024-5620
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2 PADRE PKWY STE 101
Second Line :
City : ROHNERT PARK
State : CA
Zip : 94928-2114
Country : US
Telephone Number : 760-846-6558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2016
Last Update Date : 08/20/2020

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Directions to “ CHRISTINE COLLATOS ” Practice Location

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