Christian Omar Collazo, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95033193 Issued in CA

Practice address

700 W 22ND St
Merced, CA 95340-3638

Phone

(209) 385-7140

NPI assigned

Apr 15, 2021

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thrifty Payless Inc

  dba Rite Aid Pharmacy 06833

  • Community/Retail Pharmacy
  • Winchester, CA
  • NPI 1437874062
  NPD (past)
• Thrifty Payless Inc

  dba Rite Aid Pharmacy 06007

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1972612380
  NPD (past)

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733616000000",
    "number": "1831770452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 TUPELO DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953489351",
            "telephone_number": "209-769-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W 22ND ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953403638",
            "telephone_number": "209-385-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "CHRISTIAN",
        "middle_name": "OMAR",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2024-12-08",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95033193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Cynthia Coggin
• Randy Coker, MHWII
• Albert Promis Col, M.D.
• Evelyn Coleman
• Hannah Coles
• Cheri Rena Collett, RN
• Adam Collins-Morales
• Dajour Travis Paul Collins
• Lynn Douglas Collins, LMFT
• Ramon Alphonso Collins II

• Psychiatric/Mental Health Nurse Practitioner in Merced, CA
• Providers in Merced, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.