Organization
COASTAL MINDSCAPE NURSING CORPORATION
Active
Other names
Coastal Mindscape
Organization subpart
No
Provider details
NPI number
Authorized official
DYANA KO NP (PRESIDENT)
(424) 728-5564
Entity
Organization
Contact information
Practice address
2615 PACIFIC COAST HWY STE 204, HERMOSA BEACH, CA 90254-2227
(424) 728-5564
(424) 377-6548
Mailing address
2615 PACIFIC COAST HWY STE 204, HERMOSA BEACH, CA 90254-2227
(424) 728-5564
(424) 377-6548
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/18/2024
Last updated
08/17/2025
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