Basic Information
| Provider Information | |||||||||
| NPI: | 1467803395 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLLINGTON | ||||||||
| FirstName: | MEGAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | COMMUNICARE HEALTH CENTERS | ||||||||
| Address2: | 455 1ST STREET | ||||||||
| City: | WOODLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956955323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306622211 | ||||||||
| FaxNumber: | 3020452555 | ||||||||
| Practice Location | |||||||||
| Address1: | 455 1ST ST | ||||||||
| Address2: | |||||||||
| City: | WOODLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956954023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306622211 | ||||||||
| FaxNumber: | 5302045255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2016 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.