COASTLINE BEHAVIORAL HEALTH NPI 1407216906

NPI Information

NPI: 1407216906
Provider Name: COASTLINE BEHAVIORAL HEALTH
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
2102 BUSINESS CENTER DR # 121
IRVINE, CA
ZIP 92612
Phone: (949) 300-1657
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COASTLINE BEHAVIORAL HEALTH is a psychiatric/mental health nurse practitioner in Irvine, CA. COASTLINE BEHAVIORAL HEALTH NPI is 1407216906. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2102 BUSINESS CENTER DR # 121
IRVINE, CA
ZIP 92612-001
Phone: (949) 300-1657

The provider's authorized official is Mike Priesing .
The authorized official title is Founder and has the following contact phone number (949) 300-1657.

The enumeration date for this NPI number is 2/26/2016 and was last updated on 2/26/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	300630AP	CALIFORNIA	No
2	101YM0800X	Counselor	Mental Health	300630AP	CALIFORNIA	No
3	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	300630AP	CALIFORNIA	No
4	103TP2701X	Psychologist	Group Psychotherapy	300630AP	CALIFORNIA	No
5	1041C0700X	Social Worker	Clinical	300630AP	CALIFORNIA	No
6	363LF0000X	Nurse Practitioner	Family	14445	CALIFORNIA	No
7	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	14445	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300630AP	OTHER	CALIFORNIA	DEPARTMENT OF HEALTHCARE SERVICES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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