Provider Demographics
NPI:1699112698
Name:CENTRAL COAST BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:CENTRAL COAST BEHAVIORAL HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIBERTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-540-0279
Mailing Address - Street 1:536 CAMINO MERCADO
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-1814
Mailing Address - Country:US
Mailing Address - Phone:805-540-0279
Mailing Address - Fax:805-439-1070
Practice Address - Street 1:536 CAMINO MERCADO
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-1814
Practice Address - Country:US
Practice Address - Phone:805-540-0279
Practice Address - Fax:805-439-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53324106H00000X
CAC520932084P0800X, 2084P0800X
CA19126363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty