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Contact Information

COAST TO COAST PSYCHOLOGICAL SERVICES
15497 W SAND ST
VICTORVILLE, CA92392-2910
 Phone: 760-875-5000
 Fax: 442-327-9315
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Counseling

103TC1900X 62 Psychologist, Clinical
 

Family

103TF0000X 62 Psychologist, Clinical
 

Marriage & Family Therapist

106H00000X
 

Mental Health

101YM0800X
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for COAST TO COAST PSYCHOLOGICAL SERVICES

NPI Number 1699458570
LBN Legal business name COAST TO COAST PSYCHOLOGICAL SERVICES
Authorized official ERIC BAHRA - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/08/2023
Last updated 08/08/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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