Justine Collazo, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

119202 Issued in CA

Practice address

18000 Studebaker Rd Ste 700
Cerritos, CA 90703-2684

Phone

(310) 864-0516

NPI assigned

Dec 1, 2020

Sex

Female

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 and National Provider Directory roles.

• Buena Vibra Psychological Services, Inc.

  • Psychologist
  • Cerritos, CA
  • NPI 1639891682
  NPD (past)

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1902401714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 MAPLE AVE APT 49",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905037125",
            "telephone_number": "310-626-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18000 STUDEBAKER RD STE 700",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032684",
            "telephone_number": "310-864-0516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3812 Sepulveda Blvd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905052496",
            "country_code": "US",
            "telephone_number": "213-761-8514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "JUSTINE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "119202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Christina Coddaire, LP
• Kevin John Sabandal Codilla, LVN
• Rowena Cole, NP MSN
• Stephanie Sue Coleman, R.N.
• Elizabeth Collazo
• Collective Hospice Care, Inc.
• College Hospital Cerritos
• College Hospital, Inc.
• Robert A Collen, M.D.
• Neil S Collins, LMFT

• Marriage & Family Therapist in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Marriage & Family Therapist in California

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