| Coastal Therapy Group, A Psychological Corporation | |
|
169 Saxony Rd Ste 211 Encinitas CA 92024-6780 | |
| (760) 334-6262 | |
| Not Available |
| Full Name | Coastal Therapy Group, A Psychological Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 169 Saxony Rd Ste 211, Encinitas, California |
| Authorized Official Name and Position | Reid Kessler (OWNER) |
| Authorized Official Contact | 7603346262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Therapy Group, A Psychological Corporation 169 Saxony Rd Ste 211 Encinitas CA 92024-6780 Ph: (760) 334-6262 | Coastal Therapy Group, A Psychological Corporation 169 Saxony Rd Ste 211 Encinitas CA 92024-6780 Ph: (760) 334-6262 |
| NPI Number | 1255993994 |
|---|---|
| Provider Enumeration Date | 07/02/2019 |
| Last Update Date | 11/02/2020 |
| Certification Date | 11/02/2020 |
| Medicare PECOS PAC ID | 1456776095 |
|---|---|
| Medicare Enrollment ID | O20200730000727 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255993994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lindsey Gayle Robertson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376011296 PECOS PAC ID: 2668710682 Enrollment ID: I20190215001950 |
| Provider Name | Reid Logan Kessler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093153595 PECOS PAC ID: 2365867900 Enrollment ID: I20200730000842 |
| Provider Name | Gyoung-jean Jho |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023418191 PECOS PAC ID: 9436575859 Enrollment ID: I20200817001690 |
| Provider Name | Clare M Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356688352 PECOS PAC ID: 4688927452 Enrollment ID: I20220216001823 |
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