Individual
CHRISTIAN OMAR COLLAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
700 W 22ND ST, MERCED, CA 95340-3638
(209) 385-7140
Mailing address
3212 TUPELO DR, MERCED, CA 95348-9351
(209) 769-4757
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95033193
CA
Other
Enumeration date
04/15/2021
Last updated
12/08/2024
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