Healthcare Provider Details

I. General information

NPI: 1487543690
Provider Name (Legal Business Name): PACIFIC COAST DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 GARDEN RD STE 200
MONTEREY CA
93940-5334
US

IV. Provider business mailing address

18 BATES BLVD
ORINDA CA
94563-2804
US

V. Phone/Fax

Practice location:
  • Phone: 833-328-4523
  • Fax: 831-603-6769
Mailing address:
  • Phone: 833-328-4523
  • Fax: 831-603-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MARY COLEMAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD, MPH
Phone: 833-328-4523