MEDICARE: ALICE YVONNE COLLINS

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
1	373H00000X	Day Training/Habilitation Specialist		CA
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1982746012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE YVONNE COLLINS

Provider Business Mailing Address
First Line	:	100 N BARRANCA ST STE 130
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91791-1637
Country	:	US
Telephone Number	:	626-433-1311
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 N BARRANCA ST STE 130
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91791-1637
Country	:	US
Telephone Number	:	626-962-6061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	09/11/2025

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