Active NPI
Debra Lee Collins, R.N.
- Emotionally Disturbed Childrens' Residential Treatment Facility
- San Jose, CA
National Provider Identifier
1013197052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- License
- 351052
- Practice address
- 455 Silicon Valley Blvd
San Jose, CA 95138-1858 - Phone
- (408) 284-9031
- Fax
- (408) 284-9058
- NPI assigned
- Nov 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | 351052 | CA | Primary |
Addresses
Primary practice location
455 Silicon Valley Blvd
San Jose, CA 95138-1858
Mailing address
455 Silicon Valley Blvd
San Jose, CA 95138-1858
Phone (408) 284-9031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 351052 | CA | MD | Emotionally Disturbed Childrens' Residential Treatment Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194393600000",
"number": "1013197052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 SILICON VALLEY BLVD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951381858",
"telephone_number": "408-284-9031",
"fax_number": "408-284-9058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 SILICON VALLEY BLVD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951381858",
"telephone_number": "408-284-9031",
"fax_number": "408-284-9058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "DEBRA",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-07",
"last_updated": "2007-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": "CA",
"license": "351052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.