Yvonne Collins Licensed Clinical Social Worker PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

YVONNE COLLINS LICENSED CLINICAL SOCIAL WORKER PC

Practice address

9431 Haven Ave
Suite 100
Rancho Cucuamonga, CA 91730

Phone

(909) 204-9992

Fax

(909) 204-2820

NPI assigned

Jul 20, 2022

Organization subpart

No

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

Authorized official

Name

Yvonne R Collins, MSWNPI 1063959054

Title

Owner

Phone

(909) 204-9992

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Infinity Therapy Solutions Inc Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yvonne Raenee Collins, L.C.S.W

  • Clinical Social Worker
  • Upland, CA
  • NPI 1063959054
  NPD Authorized official

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1144955527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 W FOOTHILL BLVD.",
            "address_2": "A-158",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-204-9992",
            "fax_number": "909-204-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9431 HAVEN AVE",
            "address_2": "SUITE 100",
            "city": "RANCHO CUCUAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-204-9992",
            "fax_number": "909-204-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YVONNE COLLINS LICENSED CLINICAL SOCIAL WORKER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-204-9992",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063959054",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Infinity Therapy Solutions Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Haven Surgical Center LLC
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• Diane Mitzenmacher, LCSW
• Emma Christine Ryan, DO
• Southern California Neurological Services, PC

• Clinical Social Worker in Rancho Cucuamonga, CA
• Providers in Rancho Cucuamonga, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.