Provider Demographics
NPI:1770355752
Name:KOSCHEL, DEANNA LYNN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:LYNN
Last Name:KOSCHEL
Suffix:
Gender:X
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28202 CABOT RD, STE 300
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1249
Mailing Address - Country:US
Mailing Address - Phone:949-281-8171
Mailing Address - Fax:949-281-1172
Practice Address - Street 1:12141 BROOKHURST ST STE 201
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-2865
Practice Address - Country:US
Practice Address - Phone:657-261-7140
Practice Address - Fax:714-922-1032
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95027301363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner