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General NPI Number Information
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NPI Number | 1669520854
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Entity Type | Individual
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Provider Name | NICHOLAS COLLINS PA-C, L.AC., DIPLOM.
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Gender | Male
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Dates
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Enumeration Date | 01/06/2007
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 2300 HENRY AVE
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City | PINOLE
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State | CA
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Zip | 94564-1714
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Country | US
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Telephone | 510-847-0879
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Fax |
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Provider Business Mailing Address
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Address Line | 3433 BRUNELL DR
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City | OAKLAND
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State | CA
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Zip | 94602-4104
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Country | US
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Telephone | 510-847-0879
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 10162
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA22910
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License Number State | CA
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