Nicole Lee Collman, RN, NP, CNS

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

NP15718 Issued in CA

Practice address

1779 W Yosemite Ave
Yosemite Building, Suite 200
Manteca, CA 95337-5112

Phone

(209) 825-2485

Fax

(209) 825-2499

NPI assigned

Aug 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Nicole Lee Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: ncollman100628@direct-ucsfmedicalcenter.org

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1851383244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "address_2": "STE. M195",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94122",
            "telephone_number": "415-353-2873",
            "fax_number": "415-353-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 W YOSEMITE AVE",
            "address_2": "YOSEMITE BUILDING, SUITE 200",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953375112",
            "telephone_number": "209-825-2485",
            "fax_number": "209-825-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLMAN",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "RN, NP, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SX0106X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Occupational Health",
            "state": "CA",
            "license": "CNS 2249",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "NP15718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WILSON",
            "middle_name": "LEE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bliss Watson Clark II, M.D.
• Elizabeth Ann Cliburn, DO
• Keith Clifton
• Derielle K Coleman, LCSW
• Ilene Collins
• Stephanie Colon
• Community Medical Centers Inc
• Community Medical Centers, Inc
• Community Medical Centers, Inc.
• Community Medical Centers, Inc.

• Adult Health Nurse Practitioner in Manteca, CA
• Providers in Manteca, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.