Individual
GRISELDA COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134-7000
(161) 953-2796
Mailing address
688 VANESSA DR, SAN MATEO, CA 94402-2653
(415) 867-3349
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
1124748678
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
09/02/2022
Last updated
09/16/2023
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