Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Coastal Prestige Clinic

Organization Family Psychologist · NPI 1487254413

Coastal Prestige Clinic is a Family Psychologist in Shell Beach, California. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
4

Practice location Address checks out

1677 Shell Beach Rd
Shell Beach, CA 93449-1927
Phone: (805) 416-2263
Fax: (805) 201-9134
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X
Family Psychologist Taxonomy 103TF0000X
Addiction Medicine (Family Medicine) Physician Taxonomy 207QA0401X
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X

Record details

NPI number1487254413
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Johnnie Ham — Ceo · (805) 416-2263
NPI enumeratedOctober 28, 2020
Last updated in NPPESOctober 28, 2020
Certification dateOctober 28, 2020
Mailing address1677 Shell Beach Rd, Shell Beach, CA 93449-1927