Individual
GRACE ELLEN COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
888 PROSPECT ST STE 200, LA JOLLA, CA 92037-4261
(415) 849-2466
(415) 376-4529
Mailing address
888 PROSPECT ST STE 200, LA JOLLA, CA 92037-4261
(415) 849-2466
(415) 376-4529
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95040381
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95017994
CA
Other
Enumeration date
07/20/2021
Last updated
04/28/2023
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