| Coastal Wellness Center | |
|
330 James Way Suite 180 Pismo Beach CA 93449-2878 | |
| (805) 598-0631 | |
| (805) 296-6178 |
| Full Name | Coastal Wellness Center |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 330 James Way, Pismo Beach, California |
| Authorized Official Name and Position | Christopher A Canclini (PRESIDENT) |
| Authorized Official Contact | 8055980631 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Wellness Center 330 James Way Suite 180 Pismo Beach CA 93449-2878 Ph: (805) 598-0631 | Coastal Wellness Center 330 James Way Suite 180 Pismo Beach CA 93449-2878 Ph: (805) 598-0631 |
| NPI Number | 1114373123 |
|---|---|
| Provider Enumeration Date | 05/09/2016 |
| Last Update Date | 05/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114373123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 53907 (California) | Primary |
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