Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
COASTAL COMMUNITY CENTER INC
Active
Organization
COASTAL COMMUNITY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYUSHMAAN SRINIVASA (BOARD MEMBER)
(702) 809-2505
Entity
Organization
Contact information
Practice address
3650 N UNIVERSITY AVE STE 150, PROVO, UT 84604-6636
(702) 809-2505
Mailing address
3650 N UNIVERSITY AVE STE 150, PROVO, UT 84604-6636
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/18/2025
Last updated
12/18/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up