Mitchell Collins

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3636 N 1St St
Suite 162
Fresno, CA 93726-6800

Phone

(559) 210-2773

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1174666291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 N 1ST ST STE 162",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266869",
            "telephone_number": "559-476-2166",
            "fax_number": "844-563-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 N 1ST ST",
            "address_2": "SUITE 162",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266800",
            "telephone_number": "559-210-2773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3636 N 1st St Ste 112&124",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937266800",
            "country_code": "US",
            "telephone_number": "559-476-2166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MITCHELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAFF NUMBER",
            "identifier": "100312",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Lawrence Collins, D.O.
• Dejanique Naje Collins
• Johanna Collins
• Julie Ann Collins
• Katlyn Collins
• Lucy Colmenero
• Naomi Colmenero
• Jimmy Lee Colmenro
• Harold Colomer, LVN
• Dennis Casanova Colon, CRNA

• Counselor in Fresno, CA
• Providers in Fresno, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.