Provider Demographics
NPI:1700579786
Name:JOSEPH K COLLINS
Entity Type:Organization
Organization Name:JOSEPH K COLLINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:K
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-208-1777
Mailing Address - Street 1:6162 NEDDY AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-1131
Mailing Address - Country:US
Mailing Address - Phone:818-208-1777
Mailing Address - Fax:
Practice Address - Street 1:1554 SINALOA RD UNIT 26
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3032
Practice Address - Country:US
Practice Address - Phone:818-208-1777
Practice Address - Fax:888-388-0796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty