Justin Collmann, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

27539 Issued in CA

Practice address

435 Petaluma Ave
Suite 110E
Sebastopol, CA 95472-4277

Phone

(707) 536-6956

NPI assigned

Nov 7, 2015

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1446854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446854400000",
    "number": "1386017754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 PRUNETREE CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014984",
            "telephone_number": "707-536-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PETALUMA AVE",
            "address_2": "SUITE 110E",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724277",
            "telephone_number": "707-536-6956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLMANN",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-07",
        "last_updated": "2015-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "27539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arianna Chretien-Fornaciai
• Breanna Rachell Christenson, NMT , CMT
• Theresa Clark
• Kathleen Coffey, OT
• Carol Adele Coleman, MFT
• Compassionate Concierge Care
• Compassionate Integrative Counseling PC
• Denise Marie Cooluris, ND
• Lisa Cooney, MFT, PHD
• Katherine Ross Cooper

• All providers in Sebastopol, CA
• Cognitive & Behavioral Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2015; 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.