| Gap Coastal | |
|
299 12th St Ste A Marina CA 93933-6003 | |
| (831) 647-7652 | |
| Not Available |
| Full Name | Gap Coastal |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 299 12th St Ste A, Marina, California |
| Authorized Official Name and Position | John Semo (MRT) |
| Authorized Official Contact | 8316477652 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gap Coastal 299 12th St Ste A Marina CA 93933-6003 Ph: () - | Gap Coastal 299 12th St Ste A Marina CA 93933-6003 Ph: (831) 647-7652 |
| NPI Number | 1437523735 |
|---|---|
| Provider Enumeration Date | 11/24/2015 |
| Last Update Date | 10/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437523735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Monterey County Behavioral Health Division Dba Central Coast Dtx Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2995 Rendova Rd, Marina, CA 93933 Phone: 831-755-4510 Fax: 831-424-9809 |