Central Coast Behavioral Health, Inc.
Organization Active NPI Psychiatry Physician · Arroyo Grande, CA
NPI 1699112698 · NPPES record last updated Sep 2, 2025
Key facts
- NPI
- 1699112698
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- C52093 (CA)
- Legal business name
- CENTRAL COAST BEHAVIORAL HEALTH, INC.
- Practice address
- 536 Camino Mercado
Arroyo Grande, CA 93420-1814 - Phone
- (805) 540-0279
- Fax
- (805) 439-1070
- NPI assigned
- May 30, 2013
- Organization subpart
- No
Authorized official
- Name
- Mr. Jose Feliberti, MD
- Title
- Medical Director
- Phone
- (805) 540-0279
Practitioners 25
-
Jesse Caguioa Damino, PMHNP
-
Emmanuel Ifemazi, PMHNP
-
Hayley Kincaid, NP
-
Nicole M. Rowe, APRN
-
Desiree Ruiz, RN
-
Lester James Willis, DNP, PMHNP-BC
-
Miranda Sanchez, PA-C
-
Daniel William Cable, PA-C
-
Bethania Gonzalez, FNP
-
Jennifer Yang, PMHNP
-
Bianca Iglesias, PA-C
-
Haidy Denise Willis, PMHNP
-
Elizabeth Ann Phifer, PMHNP-BC
-
Leisa King, APRN-CNP, PMHNP-BC
-
Leanne Kent, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2105018 | Central Coast Behavioral Health, Inc. | Certificate of waiver | Nov 16, 2027 |
| 05D2301050 | Central Coast Behavioral Health | Certificate of waiver | Mar 19, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250228000963 | CA | Part B Supplier - Clinic/Group Practice | 6204356660 |
Receives reassigned benefits from 17 practitioners Practice locations: El Cajon, CA; Fresno, CA; Palm Desert, CA; Arroyo Grande, CA |
National Provider Directory
Locations
536 Camino Mercado
Arroyo Grande, CA 93420
Phone (346) 502-3707
353 E Park Ave
El Cajon, CA 92020
Phone (323) 893-5844
7067 N Mariposa St
Ste 103
Fresno, CA 93720
Phone (559) 380-4304
74075 El Paseo
Ste A16
Palm Desert, CA 92260
1035 Peach St
Ste 201
San Luis Obispo, CA 93401
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist |
106H00000X | 53324 | CA | |
| Psychiatry Physician |
2084P0800X | C52093 | CA | Yes |
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | 19126 | CA |
Addresses
Primary practice location
536 Camino Mercado
Arroyo Grande, CA 93420-1814
Mailing address
536 Camino Mercado
Arroyo Grande, CA 93420-1814
Phone (805) 540-0279
Other practice location 1
7067 N Mariposa St Ste 103
Fresno, CA 93720-2988
Phone (805) 540-0279
Other names
- Pedro D. Guimaraes, M.D. Inc.
Other providers in Arroyo Grande, CA
- Susan Denise Cashier-Cozza
- Patrick Kyle Cassidy
- Alyssa Katherine Castagna
- Veronica Jenale Castilleja
- Heather Cecena
- Central Coast in Home Care Services LLC
- Central Coast Psychological Services Corporation
- Central Coast Retina Inc
- Central Coast Speech Pathology and Orofacial Myology
- Central Coast Spine and Pain Management Center, Inc.
All providers in Arroyo Grande, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.