Healthcare Provider Details

I. General information

NPI: 1255264388
Provider Name (Legal Business Name): CALI COAST PSYCHIATRIC NURSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1849 SAWTELLE BLVD STE 610
LOS ANGELES CA
90025-7013
US

IV. Provider business mailing address

11357 NUCKOLS RD STE 2091
GLEN ALLEN VA
23059-5504
US

V. Phone/Fax

Practice location:
  • Phone: 804-965-4327
  • Fax:
Mailing address:
  • Phone:
  • 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: DR. DEBORAH CRUTCHFIELD
Title or Position: OWNER
Credential: PMHNP
Phone: 804-965-4327