Jesse F Collins Jr., P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA19628 Issued in CA

Practice address

6221 Wilshire Blvd
Suite 416
Los Angeles, CA 90048-5201

Phone

(323) 938-9999

Fax

(323) 456-0880

NPI assigned

Mar 31, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lawrence a. Mora MD Inc

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1912930512
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1124290028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 PARKGLEN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900431014",
            "telephone_number": "323-291-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD",
            "address_2": "SUITE 416",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485201",
            "telephone_number": "323-938-9999",
            "fax_number": "323-456-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JESSE",
        "middle_name": "F",
        "name_suffix": "Jr.",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Irene Collins, NP
• Jacob Daniel Collins, PA-C
• Jaysanna Collins
• Jennifer L Collins
• Jennifer L. Collins, L.C.S.W.
• Jocella Collins
• John Collins, IMFT
• John C. Collins, MD
• Jolene Elizabeth Collins, MD
• Jordan Collins

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.