Provider Demographics
NPI:1164679825
Name:COLLADO, JOPER ELIZE (RN)
Entity Type:Individual
Prefix:
First Name:JOPER
Middle Name:ELIZE
Last Name:COLLADO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 CEDRO LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3405
Mailing Address - Country:US
Mailing Address - Phone:510-303-5786
Mailing Address - Fax:
Practice Address - Street 1:1800 ADOBE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2313
Practice Address - Country:US
Practice Address - Phone:925-825-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA675602163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse