PACIFIC COAST PSYCHIATRIC ASSOCIATES, INC. (NPI# 1063044410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063044410 |
| Entity Type | Organization |
| Organization Name | PACIFIC COAST PSYCHIATRIC ASSOCIATES, INC. |
| Practice Address |
4550 Kearny Villa Rd Ste 116 San Diego CA 92123-1583 |
| Mailing Address |
490 Post St Ste 1043 San Francisco CA 94102-1301 |
| Practice Telephone | 8582791223 |
| Mailing Telephone | 9252314325 |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-10 |
| Authorized Official Name | ANISHA PATEL-DUNN (CEO) |
| Authorized Official Telephone | 4154090944 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6386 Alvarado Ct Ste 210, San Diego, CA 921204907 | 8582791223 | |
| 300 Rancheros Dr Ste 130, San Marcos, CA 920692968 | 8582791223 | |
| 12264 El Camino Real Ste 203, San Diego, CA 921303061 | 8582791223 | |
| 15611 Pomerado Rd Ste 535, Poway, CA 920642437 | 8582791223 | |
| 2452 Fenton St Ste 202, Chula Vista, CA 919144551 | 8582791223 | |
| 3609 Ocean Ranch Blvd Ste 208, Oceanside, CA 920562698 | 8582791223 | |
| 31573 Rancho Pueblo Rd Ste 200, Temecula, CA 925924835 | 8582791223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023125465 | Pacific Coast Psychiatric Associates, Inc. | Psychiatry & Neurology | 490 Post St Ste 1043, San Francisco, CA 94102-1301 | 2006-08-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PACIFIC COAST PSYCHIATRIC ASSOCIATES, INC. | 10655 Ne 4th St Ste 901, Bellevue, WA 98004-5030 |
| Street Address |
4550 KEARNY VILLA RD STE 116 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-1583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801811104 | Raphael Adam Morris | Psychiatry & Neurology | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2006-07-13 |
| 1760986947 | Robin Lee Anderson | Marriage & Family Therapist | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2018-03-21 |
| 1184133431 | Desiree Brittain | Marriage & Family Therapist | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2017-09-28 |
| 1053773986 | Lori Krueger | Marriage & Family Therapist | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2016-03-21 |
| 1538538582 | Melanie Dawson | Marriage & Family Therapist | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2015-09-21 |
| 1407285356 | Debra Benaderet | Social Worker | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2013-11-01 |
| 1053665182 | Henry Soron Petersen | Social Worker | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2012-10-26 |
| 1225306590 | Kelly Cohen | Marriage & Family Therapist | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2011-12-01 |
| 1821377433 | Debra Berl | Social Worker | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2011-08-12 |
| 1437394046 | Robyn Firtel | Marriage & Family Therapist | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2008-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729718 | Cynthia Felicia Delaney | Community/Behavioral Health | 4887 Bella Pacific Row Unit 240, San Diego, CA 92109-8515 | 2020-10-31 |
| 1790390359 | Institute of Behavioral Sciences and Technology Family Counseling | Community/Behavioral Health | 9655 Granite Ridge Dr Ste Ofc2005, San Diego, CA 92123-2674 | 2020-09-10 |
| 1902426018 | Clayton Counseling Licensed Clinical Social Worker Inc. | Community/Behavioral Health | 2180 Garnet Ave Ste 2e, San Diego, CA 92109-3675 | 2020-04-17 |
| 1679113765 | Kristina Copley Marriage and Family Therapy, Inc | Community/Behavioral Health | 1267 Rosecrans St Ste B, San Diego, CA 92106-2692 | 2020-01-07 |
| 1417598319 | Open Heart Leaders | Community/Behavioral Health | 1913 Euclid Ave Ste 108, San Diego, CA 92105-5360 | 2019-10-01 |
| 1710531405 | Katherine Raftery | Community/Behavioral Health | 3570 Granada Ave, San Diego, CA 92104-4145 | 2019-07-31 |
| 1063064509 | Abigail Frances Swan | Community/Behavioral Health | 3376 Grim Ave Apt 3, San Diego, CA 92104-4650 | 2019-07-15 |
| 1548726862 | Unscripted Learning | Community/Behavioral Health | 3717 India St, San Diego, CA 92103-3727 | 2019-02-11 |
| 1356806509 | Vista Hill Foundation | Community/Behavioral Health | 8825 Aero Drive, Suite 315, San Diego, CA 92123-1104 | 2019-02-01 |
| 1891275707 | Kelley Kozlowski | Community/Behavioral Health | 4804 Iroquois Ave, San Diego, CA 92117-6248 | 2018-08-20 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.