Healthcare Provider Details

I. General information

NPI: 1942642590
Provider Name (Legal Business Name): OSCAR COLLINS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10413 SPADE DR
LOMA LINDA CA
92354-2013
US

IV. Provider business mailing address

501 W REDLANDS BLVD STE B
REDLANDS CA
92373-4642
US

V. Phone/Fax

Practice location:
  • Phone: 909-663-9589
  • Fax: 909-494-7652
Mailing address:
  • Phone: 909-686-6233
  • Fax: 909-353-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW81067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: