Healthcare Provider Details

I. General information

NPI: 1558288902
Provider Name (Legal Business Name): COASTAL HORIZON NURSING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2988 WOODBURY CT
CARLSBAD CA
92010-6545
US

IV. Provider business mailing address

2988 WOODBURY CT
CARLSBAD CA
92010-6545
US

V. Phone/Fax

Practice location:
  • Phone: 760-224-8361
  • Fax:
Mailing address:
  • Phone: 760-224-8361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PAUL MATA
Title or Position: OWNER/PRESIDENT
Credential: PMHNP-BC
Phone: 760-224-8361