Coastline Community Health

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

PSY15775 Issued in CA

Legal business name

COASTLINE COMMUNITY HEALTH

Doing business as

Dogtown Community Health

Practice address

2009 Main St
Santa Monica, CA 90405-1021

Phone

(818) 880-0250

NPI assigned

Mar 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Rhonda Jessum, PH.D.

Title

Founder and Director

Phone

(818) 880-0250

Specialties & licenses 2

Addresses

Other names 1

• Dogtown Community Health Doing business as

Locations

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1679967475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4831 LAS VIRGENES RD # 177",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021911",
            "telephone_number": "818-880-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 MAIN ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051021",
            "telephone_number": "818-880-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "JESSUM",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "FOUNDER AND DIRECTOR",
        "authorized_official_telephone_number": "818-880-0250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": "PSY15775",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "HI",
            "license": "PSY-1519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dogtown Community Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clifford Segil DO a Medical Corporation
• Caroline Close, MD
• Damon Cluff
• Deborah Cluff, MA, MFTI
• Coastal Health Care, Inc. (Brentwood Health Care Center)
• Joshua David Cobia, RADT
• Mary Katherine Cocharo, LMFT
• Catherine Elizabeth Cochet
• Marc Everett Code, C.R.N.A.
• Christian Codesido

• Mental Health Clinic/Center (Including Community Mental Health Center) in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.