Healthcare Provider Details

I. General information

NPI: 1750928255
Provider Name (Legal Business Name): CRISTINA D COLLASO CAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2019
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15670 E MEXICO AVE
AURORA CO
80017-5001
US

IV. Provider business mailing address

15670 E MEXICO AVE
AURORA CO
80017-5001
US

V. Phone/Fax

Practice location:
  • Phone: 720-907-5242
  • Fax:
Mailing address:
  • Phone: 720-907-5242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACA.0007581
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: