Provider Demographics
NPI:1659441061
Name:COLLINS, CHRISTINE L (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:L
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 EMMETT AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3522
Mailing Address - Country:US
Mailing Address - Phone:805-791-5012
Mailing Address - Fax:
Practice Address - Street 1:1227 E LA AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2871
Practice Address - Country:US
Practice Address - Phone:805-582-4075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA361717163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA361717OtherRN