Provider Demographics
NPI:1801969316
Name:COLLINS, MARIA LOUISE (MSW)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LOUISE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15942 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2102
Mailing Address - Country:US
Mailing Address - Phone:510-777-5300
Mailing Address - Fax:
Practice Address - Street 1:15942 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2102
Practice Address - Country:US
Practice Address - Phone:510-777-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical