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General NPI Number Information
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NPI Number | 1235949256
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Entity Type | Individual
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Provider Name | SHAKAYLA COLLINS
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Gender | Female
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 21622 MARGUERITE PKWY APT 342
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City | MISSION VIEJO
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State | CA
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Zip | 92692-4418
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Country | US
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Telephone | 520-449-7015
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 312
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City | LAKE FOREST
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State | CA
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Zip | 92609-0312
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 17704
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License Number State | CA
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