Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Coastal Psychiatry Care Professional Nursing Corp

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1336062777

Coastal Psychiatry Care Professional Nursing Corp provides Psychiatric/Mental Health Nurse Practitioner services in Pismo Beach, California. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

128 La Colima
Pismo Beach, CA 93449
Phone: (805) 608-5310
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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 NPPESSeptember 8, 2026
Certification dateSeptember 8, 2026
Mailing address567 Five Cities Dr Ste 418, Pismo Beach, CA 93449-3005

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