Healthcare Provider Details

I. General information

NPI: 1508379025
Provider Name (Legal Business Name): SUNSHINE COLLINS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9163 W FLAMINGO RD STE 120
LAS VEGAS NV
89147-6458
US

IV. Provider business mailing address

9163 W FLAMINGO RD STE 120
LAS VEGAS NV
89147-6458
US

V. Phone/Fax

Practice location:
  • Phone: 702-363-3332
  • Fax: 702-869-9203
Mailing address:
  • Phone: 702-363-3332
  • Fax: 702-869-9203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY0796
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY0796
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPY0796
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPY0796
License Number StateNV
# 5
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY0796
License Number StateNV

VIII. Authorized Official

Name: DR. SUNSHINE COLLINS
Title or Position: OWNER/MANAGING MEMBER
Credential: PSYD
Phone: 702-363-3332