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NPI Code Detail

MEDICARE: COLLABRIA CARE

MEDICARE: COLLABRIA CARE
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
1261QA0600XAdult Day Care Clinic/Center070000499CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972506624
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLLABRIA CARE
Provider Business Mailing Address
First Line : 414 S JEFFERSON ST
Second Line :
City : NAPA
State : CA
Zip : 94559-4515
Country : US
Telephone Number : 707-258-9087
Fax Number : 707-254-4157
Provider Business Practice Location Address
First Line : 414 S JEFFERSON ST
Second Line :
City : NAPA
State : CA
Zip : 94559-4515
Country : US
Telephone Number : 707-258-9087
Fax Number : 707-254-4157
Authorized Official
Title or Position : ASSISTANT SECRETARY OF ENROLLMENTS
Name : DONALD W ANDERSON JR.
Credential :
Telephone Number : 425-358-9786
Provider Enumeration Date : 05/25/2005
Last Update Date : 05/15/2025

Similar Medicare Providers

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414 S JEFFERSON ST
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94559-4515
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1316937261 — DR. ELIZABETH A DURKIN M.D.
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1700505617 — COLLABRIA CARE
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1093537219 — CP NAPA N-CA HOSPICE, LLC
Practice Location Address:
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1144027723 — GAIL RAZI
Practice Location Address:
414 S JEFFERSON ST
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1932065448 — COMPASSUS OF CALIFORNIA PHYSICIANS GROUP, P.C.
Practice Location Address:
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Practice Fax:

Directions to “COLLABRIA CARE ” Practice Location

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