Collister, Timothy
Collister, Timothy is an sole proprietor health care provider with primary practice located at 7024 Seville Ave Ste D, Huntington Park CA 90255-4969. He recently has 8 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Collister, Timothy can be contacted via phone (323) 588-9600.Contact Information
Primary practice address
7024 Seville Ave Ste D
Huntington Park CA 90255-4969
Phone: (323) 588-9600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | PSY12895 | California |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY12895 | California |
| Behavioral Health & Social Service Providers / Adult Development & Aging | 103TA0700X | PSY12895 | California |
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | PSY12895 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY12895 | California |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | PSY12895 | California |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | ||
| Behavioral Health & Social Service Providers / Family | 103TF0000X | PSY12895 | California |
| Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities | 103TM1800X | PSY12895 | California |
Profile Details
| NPI number | 1659436491 |
|---|---|
| LBN Legal business name | Collister, Timothy |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659436491 | NPPES |
| California | MEDICAID | PSY128950 | |
| California | MEDICAID | PSY128951 |
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