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

Coastal Psychiatry Care Profess

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1336062777

Coastal Psychiatry Care Profess is a Psychiatric/Mental Health Nurse Practitioner in Pismo Beach, California. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

128 La Colima
Pismo Beach, CA 93449
Phone: (805) 608-5310
Show map & directions

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

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1336062777
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Anna Hadilaksono — Owner · (805) 608-5310
NPI enumeratedAugust 3, 2026
Last updated in NPPESAugust 3, 2026
Certification dateJuly 21, 2026
Mailing address128 La Colima, Pismo Beach, CA 93449-2841