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Individual

MICHAEL COLLIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPT

Contact information

Practice address
5810 RALSTRON ST, 2ND FLOOR, VENTURA, CA 93003
(805) 642-7033
(805) 624-7201
Mailing address
5260 SAN ANSELMO RD, ATASCADERO, CA 93422-2528
(805) 642-7033
(805) 642-7201

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
30793
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
167G00000X
LICENSED PSYCHIATRIC TECHNICIAN
CA
Enumeration date
01/26/2012
Last updated
01/26/2012
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