Coastal Connection, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

COASTAL CONNECTION, LLC

Practice address

209 Avenida del Mar Ste 207J
San Clemente, CA 92672-4078

Phone

(949) 533-3046

Fax

(949) 288-6231

NPI assigned

May 25, 2026

Organization subpart

No

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

Authorized official

Name

Michael Villarreal

Title

Coo

Phone

(949) 533-3046

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1779667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781740800000",
    "number": "1467383075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 AVENIDA DEL MAR STE 207J",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724078",
            "telephone_number": "949-533-3046",
            "fax_number": "949-288-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 AVENIDA DEL MAR STE 207J",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724078",
            "telephone_number": "949-533-3046",
            "fax_number": "949-288-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CONNECTION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-25",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "949-533-3046"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Chumley
• Jillian Elizabeth Church, RDH, OMT
• Jennifer Cipollone
• City of San Clemente
• Grace Victoria Clark, MD
• Emily A Cobb
• Cogent Diagnostic Laboratories, Inc.
• Cole Vision Corporation
• Ansley Colebank, MS, OTR/L
• Colin X Jairam MD Inc (Hybrid MD)

• Adult Mental Health Clinic/Center in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.