Coastline Behavioral Health

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

14445 Issued in CA

Legal business name

COASTLINE BEHAVIORAL HEALTH

Practice address

2102 Business Center Dr # 121
Irvine, CA 92612-1001

Phone

(949) 300-1657

NPI assigned

Feb 26, 2016

Last updated

Feb 26, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

COASTLINE RECOVERY LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mike Priesing, MHW CATC

Title

Founder

Phone

(949) 300-1657

Specialties & licenses 7

Addresses

Other identifiers 1

Part of

Coastline Recovery LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Coastline Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Huntington Beach, CA
  • NPI 1306217500
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1407216906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 BUSINESS CENTER DR # 121",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121001",
            "telephone_number": "949-300-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 BUSINESS CENTER DR # 121",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121001",
            "telephone_number": "949-300-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE BEHAVIORAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTLINE RECOVERY LLC",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "PRIESING",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "949-300-1657",
        "authorized_official_credential": "MHW CATC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "300630AP",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "300630AP",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "300630AP",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "300630AP",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "300630AP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "14445",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "14445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTHCARE SERVICES",
            "identifier": "300630AP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mati Cobb, NP

• Psychiatric/Mental Health Nurse Practitioner in Irvine, CA
• Providers in Irvine, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.