Ilene Collins

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

302 Cherry LN Ste 201
Manteca, CA 95337-4311

Phone

(209) 478-9862

NPI assigned

Nov 30, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• California Psychological Institute

  • Marriage & Family Therapist
  • Fresno, CA
  • NPI 1821179276
  NPD (past)

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1396259222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 CHERRY LN STE 201",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374311",
            "telephone_number": "646-241-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CHERRY LN STE 201",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374311",
            "telephone_number": "209-478-9862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1470 W Herndon Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937110552",
            "country_code": "US",
            "telephone_number": "559-256-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 NW 167th St",
            "address_purpose": "LOCATION",
            "city": "Miami Gardens",
            "state": "FL",
            "postal_code": "330564838",
            "country_code": "US",
            "telephone_number": "305-624-7450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3133 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-600-6180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "ILENE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2024-05-10",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rudy Ciccarelli, DDS
• Bliss Watson Clark II, M.D.
• Elizabeth Ann Cliburn, DO
• Keith Clifton
• Derielle K Coleman, LCSW
• Nicole Lee Collman, RN, NP, CNS
• Stephanie Colon
• Community Medical Centers Inc
• Community Medical Centers, Inc
• Community Medical Centers, Inc. (Community Medical Center)

• Community Health Worker in Manteca, CA
• Providers in Manteca, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.