NPIMap

Organization Active NPI

Central Coast Psychological Services Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arroyo Grande, CA
National Provider Identifier
1821753690
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CENTRAL COAST PSYCHOLOGICAL SERVICES CORPORATION
Practice address
152 W Branch St Ste a
Arroyo Grande, CA 93420-6616
Phone
(805) 801-2231
Fax
(805) 335-6859
NPI assigned
Nov 5, 2021
Last updated
Dec 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Authorized official

Name
Dr. Kristyn Collins, PHDNPI 1831688795
Title
Psychologist
Phone
(805) 235-0251

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

152 W Branch St Ste a
Arroyo Grande, CA 93420-6616

Mailing address

PMB 515 1375 E. Grand Ave.
Suite #103
Arroyo Grande, CA 93420

Other practice location 1

227 S Halcyon Rd Ste 101
Arroyo Grande, CA 93420-3174
Phone (805) 801-2231

Other practice location 2

1172 E Grand Ave
Arroyo Grande, CA 93420-2556
Phone (805) 235-0251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211214001066 CA Part B Supplier - Clinic/Group Practice 2264822808 Receives reassigned benefits from 8 practitioners
Practice locations: Arroyo Grande, CA

National Provider Directory

National Provider Directory

Locations

1172 E Grand Ave
Arroyo Grande, CA 93420
Phone (805) 210-0472

1375 E Grand Ave
Ste 103
Arroyo Grande, CA 93420

152 W Branch St
Ste A
Arroyo Grande, CA 93420
Phone (805) 801-2231

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1821753690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 515 1375 E. GRAND AVE.",
            "address_2": "SUITE #103",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "93420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 W BRANCH ST STE A",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934206616",
            "telephone_number": "805-801-2231",
            "fax_number": "805-335-6859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "227 S Halcyon Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Arroyo Grande",
            "state": "CA",
            "postal_code": "934203174",
            "country_code": "US",
            "telephone_number": "805-801-2231",
            "fax_number": "805-335-6859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1172 E Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Arroyo Grande",
            "state": "CA",
            "postal_code": "934202556",
            "country_code": "US",
            "telephone_number": "805-235-0251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL COAST PSYCHOLOGICAL SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-05",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "KRISTYN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "805-235-0251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.