Organization Active NPI

South Coast Counseling, Inc.

  • Substance Abuse Rehabilitation Facility
  • Costa Mesa, CA
National Provider Identifier
1609209097
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
300012BN Issued in CA
Legal business name
SOUTH COAST COUNSELING, INC.
Practice address
693 Plumer St
Costa Mesa, CA 92627-2720
Phone
(949) 642-0180
NPI assigned
Aug 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Authorized official

Name
Mr. Tahamtan Nematbakhsh, JD
Title
Ceo
Phone
(949) 642-0180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 300012BN CA Primary

Addresses

Primary practice location

693 Plumer St
Costa Mesa, CA 92627-2720

Mailing address

693 Plumer St
Costa Mesa, CA 92627-2720
Phone (949) 642-0180

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2070195South Coast Counseling Inc693 Plumer St, Costa Mesa, CA 92627Certificate of waiverDec 9, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1609209097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "693 PLUMER ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272720",
            "telephone_number": "949-642-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 PLUMER ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272720",
            "telephone_number": "949-642-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COAST COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "NEMATBAKHSH",
        "authorized_official_first_name": "TAHAMTAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-642-0180",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300012BN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.