Healthcare Provider Details

I. General information

NPI: 1356998439
Provider Name (Legal Business Name): CAITLIN JAY COLLINS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 7TH ST STE 1E
SACRAMENTO CA
95814-5445
US

IV. Provider business mailing address

1500 7TH ST STE 1E
SACRAMENTO CA
95814-5445
US

V. Phone/Fax

Practice location:
  • Phone: 916-806-9096
  • Fax:
Mailing address:
  • Phone: 916-806-9096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number33761
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number33761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: