Provider Demographics
NPI:1215824974
Name:ENDO, COLIN TAKASHI
Entity type:Individual
Prefix:MR
First Name:COLIN
Middle Name:TAKASHI
Last Name:ENDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BERESFORD PL
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-4244
Mailing Address - Country:US
Mailing Address - Phone:650-284-6381
Mailing Address - Fax:
Practice Address - Street 1:6 BERESFORD PL # A
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-4244
Practice Address - Country:US
Practice Address - Phone:650-284-6381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician