Coyote Coast Youth and Family Counseling, Inc

Key facts

NPI: 1669769816
Entity type: Organization (NPI type 2)
Primary specialty: Community/Behavioral Health Agency 251S00000X
Legal business name: COYOTE COAST YOUTH AND FAMILY COUNSELING, INC
Practice address: 104 Camino Pablo
Orinda, CA 94563-2203
Phone: (925) 258-5400
Fax: (925) 258-5400
NPI assigned: Jul 7, 2011
Organization subpart: No

Authorized official

Name: Shamita Dhar, LCSW
Title: Director of Operations
Phone: (925) 258-5402

Practitioners 2

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

Alex Georgakopoulos, MFT Marriage & Family Therapist · Orinda, CA · NPI 1235690710

NPD (past)
Benito Murguia, MSW Student in an Organized Health Care Education/Training Program · San Leandro, CA · NPI 1669932604

NPD (past)

National Provider Directory

Locations

104 Camino Pablo
Orinda, CA 94563
Phone (925) 258-5400

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Community/Behavioral Health Agency	251S00000X			Yes

Addresses

Primary practice location

104 Camino Pablo
Orinda, CA 94563-2203

Mailing address

104 Camino Pablo
Orinda, CA 94563-2203
Phone (925) 258-5400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 7, 2011.

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1669769816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CAMINO PABLO",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632203",
            "telephone_number": "925-258-5400",
            "fax_number": "925-258-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CAMINO PABLO",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632203",
            "telephone_number": "925-258-5400",
            "fax_number": "925-258-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COYOTE COAST YOUTH AND FAMILY COUNSELING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "DHAR",
        "authorized_official_first_name": "SHAMITA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "925-258-5402",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orinda, CA

All providers in Orinda, CA · Community/Behavioral Health Agency in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.