Healthcare Provider Details

I. General information

NPI: 1326060617
Provider Name (Legal Business Name): HELEN COLLINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SOTOYOME ST
SANTA ROSA CA
95405-4823
US

IV. Provider business mailing address

121 SOTOYOME ST
SANTA ROSA CA
95405-4823
US

V. Phone/Fax

Practice location:
  • Phone: 707-546-4062
  • Fax: 707-525-4071
Mailing address:
  • Phone: 707-546-4062
  • Fax: 707-525-4071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA50966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: