Provider Demographics
NPI:1942642590
Name:COLLINS, OSCAR (LCSW)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:COLLINS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10413 SPADE DR
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2013
Mailing Address - Country:US
Mailing Address - Phone:909-663-9589
Mailing Address - Fax:909-494-7652
Practice Address - Street 1:308 W STATE ST
Practice Address - Street 2:STE 3D
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4653
Practice Address - Country:US
Practice Address - Phone:909-566-9669
Practice Address - Fax:909-353-4985
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CALCSW810671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical