Organization
COLLABRIA CARE
Active
Other names
Providence PACE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
414 S JEFFERSON ST, NAPA, CA 94559-4515
(707) 254-4159
(707) 699-1557
Mailing address
PO BOX 31001-3064, PASADENA, CA 91110-3064
(707) 254-4159
(707) 699-1557
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
08/24/2022
Last updated
05/14/2025
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