Organization
COASTAL PSYCHOLOGICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER LEATH PSYD (PRESIDENT)
(949) 385-2775
Entity
Organization
Contact information
Practice address
1400 QUAIL ST STE 136, NEWPORT BEACH, CA 92660-2788
(949) 385-2775
(949) 336-3763
Mailing address
1400 QUAIL ST STE 136, NEWPORT BEACH, CA 92660-2788
(949) 385-2775
(949) 336-3763
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY26109
CA
Other
Enumeration date
04/09/2018
Last updated
05/31/2024
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