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NPI Code Detail

MEDICARE: MS. KATHLEEN ANN COLLINS LCSW

MEDICARE: MS. KATHLEEN ANN COLLINS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker24671CA

General Provider Information

NPI Number : 1437240538
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN ANN COLLINS LCSW
Provider Business Mailing Address
First Line : 2124 MAIN ST
Second Line : SUITE 165
City : HUNTINGTON BEACH
State : CA
Zip : 92648-2405
Country : US
Telephone Number : 714-536-0077
Fax Number : 714-434-2675
Provider Business Practice Location Address
First Line : 2124 MAIN ST
Second Line : SUITE 165
City : HUNTINGTON BEACH
State : CA
Zip : 92648-2405
Country : US
Telephone Number : 714-536-0077
Fax Number : 714-434-2675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 02/09/2010

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