Individual provider Active NPI

Jeffrey Tomoya Collins

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1255214243
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95036010 Issued in CA
Practice address
6280 Jackson Dr Ste 9
San Diego, CA 92119-3436
Phone
(619) 303-3642
NPI assigned
Jul 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95036010 CA Primary

Addresses

Primary practice location

6280 Jackson Dr Ste 9
San Diego, CA 92119-3436

Mailing address

800 Broadway Apt 2501
San Diego, CA 92101-5663
Phone (808) 349-8689

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

State licenses

LicenseStateTypeSpecialty
95036010CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mismo Dermatology Group Apc CurrentSince Aug 3, 2025 Accepting new patients

Locations

6280 Jackson Dr
Ste 9
San Diego, CA 92119
Phone (619) 303-3642

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1255214243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BROADWAY APT 2501",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015663",
            "telephone_number": "808-349-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6280 JACKSON DR STE 9",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921193436",
            "telephone_number": "619-303-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JEFFREY",
        "middle_name": "TOMOYA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95036010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.