Individual
DR. SHALEISE COLLIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
901 DOVER DR STE 210, NEWPORT BEACH, CA 92660-5500
(949) 413-5070
Mailing address
PO BOX 946, CORONA DEL MAR, CA 92625-5946
(949) 413-5070
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
33519
CA
103T00000X
Psychologist
33519
CA
103TC2200X
Clinical Child & Adolescent Psychologist
33519
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2015
Last updated
02/10/2023
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