MRS. DEBRA LEE COLLINS (NPI# 1013197052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013197052 |
Entity Type | Individual |
Full Name | MRS. DEBRA LEE COLLINS |
Credential | R.N. |
Practice Address |
455 Silicon Valley Blvd San Jose CA 95138-1858 |
Practice Telephone | 4082849031 |
Practice Fax Number | 4082849058 |
Mailing Telephone | 4082849031 |
Mailing Fax Number | 4082849058 |
Enumeration Date | 2007-11-07 |
Last Update Date | 2007-11-07 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 351052 | CA | Residential Treatment Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174913222 | Debra Collins | Licensed Practical Nurse | 19020 W Miltona Rd Ne, Parkers Prairie, MN 56361-8143 | 2015-01-28 |
1790122836 | Debra Lynne Collins | Massage Therapist | 10926 Rainier Ave S, Seattle, WA 98178-3215 | 2013-05-30 |
1558531772 | Debra Jean Collins | Counselor | 10615 Sagebriar Drive, Houston, TX 77089 | 2008-03-04 |
1093983439 | Debra Dawn Collins | Massage Therapist | 333 E 8th St, Port Angeles, WA 98362-6217 | 2008-02-19 |
1124246830 | Debra Kay Collins | Licensed Practical Nurse | 1138 Castle St, Portsmouth, OH 45662-5331 | 2007-04-20 |
1831227537 | Debra Collins | Marriage & Family Therapist | 775 E Blithedale Ave, #111, Mill Valley, CA 94941-1554 | 2007-03-02 |
1508967159 | Debra Cobb Collins | Registered Nurse | 5823 Highway 22, Michie, TN 38357-5175 | 2006-09-26 |
1083128987 | Debra Collins | Counselor | 1008 Venice Ave, Hammond, LA 70403 | 2017-11-30 |
1003363896 | Debra T. Collins | Nurse Practitioner | 1508 K V Rd, Victoria, VA 23974-2624 | 2016-09-08 |
1447614144 | Debra Collins | Social Worker | 4001 W Dayton St, Mchenry, IL 60050-8377 | 2016-04-08 |
Street Address |
455 SILICON VALLEY BLVD |
City | SAN JOSE |
State | CA |
Zip Code | 95138-1858 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306938402 | Starlight Adolescent Center | Community/Behavioral Health | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2006-09-28 |
1124681127 | Kruti Rawal | Pharmacist | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2019-04-16 |
1144600784 | Ana Lopez Rojas | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2015-06-08 |
1508252149 | Sjbh, LLC | Psychiatric Hospital | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2015-04-10 |
1053632059 | Nathaniel Grant Sharon | Psychiatry & Neurology | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2010-06-14 |
1477784775 | Crystal Estrada | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2009-08-04 |
1508039124 | Peter Hernandez | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2008-04-03 |
1841460995 | Lashurn Michelle Ferrell | Counselor | 455 Silicon Valley Blvd, Human Resources, San Jose, CA 95138-1858 | 2008-03-05 |
1376712174 | John Mark Kane | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2008-02-26 |
1154599892 | Mei-yan Chiang | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2008-02-15 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023623865 | Nguyen and Tran Dental Corporation | Dentist | 6130 Hellyer Avenue, San Jose, CA 95138 | 2020-09-09 |
1821564485 | Indian Health Center of Santa Clara Valley | Clinic/Center | 9501 Malech Rd, San Jose, CA 95138 | 2018-10-22 |
1548690324 | Megan Chang | Occupational Therapist | 5900, Pistoia Way, San Jose, CA 95138 | 2013-11-15 |
1720428410 | Cristina Duenas | Social Worker | 5855 Silver Creek Valley Pl, San Jose, CA 95138 | 2013-06-27 |
1174967079 | Guardian Sleep Clinic, LLC | Clinical Medical Laboratory | 315 Piercy Rd, San Jose, CA 95138 | 2013-04-22 |
1871847889 | Rebecca Kerry Van Sickle | Counselor | 9500 Malech Rd, San Jose, CA 95138 | 2012-10-30 |
1366720906 | Ariosa Diagnostics, Inc. | Clinical Medical Laboratory | 5945 Optical Court, San Jose, CA 95138 | 2011-08-01 |
1043406713 | Umaru Fofana | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138 | 2007-09-17 |
1316140569 | Dickman & Bourla Chiropractic Inc | Chiropractor | 2311 Silver Breeze Ct, San Jose, CA 95138 | 2007-06-06 |
1508983032 | Traci Pickett | Counselor | 9500 Malech Road, San Jose, CA 95138 | 2007-03-22 |
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Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104151059 | Emq Families First | Residential Treatment Facility, Emotionally Disturbed Children | 6630 Marymonte Ct, San Jose, CA 95120-4517 | 2009-10-10 |
1134316722 | Lindsay Marie Blackwell | Residential Treatment Facility, Emotionally Disturbed Children | 463 Wooster Ave Apt D23, San Jose, CA 95116-1096 | 2007-09-27 |
1700101540 | Kyle Addison | Residential Treatment Facility, Emotionally Disturbed Children | 6630 Marymonte Ct, San Jose, CA 95120-4517 | 2010-04-05 |
1255475497 | Jennifer Marie Crane | Residential Treatment Facility, Emotionally Disturbed Children | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2007-02-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.