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General NPI Number Information
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NPI Number | 1144955527
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Entity Type | Organization
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Legal Business Name | YVONNE COLLINS LICENSED CLINICAL SOCIAL WORKER PC
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 9431 HAVEN AVE SUITE 100
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City | RANCHO CUCUAMONGA
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State | CA
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Zip | 91730
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Country | US
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Telephone | 909-204-9992
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Fax | 909-204-2820
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Provider Business Mailing Address
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Address Line | 154 W FOOTHILL BLVD. A-158
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City | UPLAND
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State | CA
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Zip | 91786
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Country | US
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Telephone | 909-204-9992
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Fax | 909-204-2820
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Authorized Official
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Title or Position | OWNER
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Name | YVONNE R COLLINS
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Credential | MSW
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Telephone | 909-204-9992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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