Coastal Counseling & Coaching, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

20446 Issued in CA

Legal business name

COASTAL COUNSELING & COACHING, INC

Practice address

280 Newport Center Dr
Suite 200
Newport Beach, CA 92660-7526

Phone

(949) 222-6688

Fax

(949) 716-7885

NPI assigned

Apr 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kathleen Anne Nickerson, PHDNPI 1639219694

Title

Owner/President

Phone

(949) 222-6688

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathleen Anne Nickerson, PHD

  • Clinical Psychologist
  • Newport Beach, CA
  • NPI 1639219694
  NPD (past) Authorized official

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211068800000",
    "number": "1437322237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 NEWPORT CENTER DR",
            "address_2": "SUITE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607526",
            "telephone_number": "949-222-6688",
            "fax_number": "949-716-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 NEWPORT CENTER DR",
            "address_2": "SUITE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607526",
            "telephone_number": "949-222-6688",
            "fax_number": "949-716-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL COUNSELING & COACHING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-05-18",
        "status": "A",
        "authorized_official_last_name": "NICKERSON",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "949-222-6688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "20446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - KFN",
            "identifier": "PSY20446A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE - KFN",
            "identifier": "20446",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA CORPORATION",
            "identifier": "C2942646",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CM Providers Medical Group, PC
• Coast OB-GYN
• Coast Spine and Sports Medicine Surgery Center LLC
• Coast to Coast Anesthesia Services, LLC
• Coastal Care Mobile Physical Therapy Apc
• Coastal Eye Care, a Medical Corporation
• Coastal Kids, a Professional Medical Corporation
• Coastal Minds Counseling Center
• Coastal Psychological Services, Inc.
• Coastal Recovery Health and Wellness, Inc.

• Community/Behavioral Health Agency in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2008; 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.