OC LIGHT HOUSE NPI 1376191148

NPI Information

NPI: 1376191148
Provider Name: OC LIGHT HOUSE
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Organization
Address:
150 S PROSPECT AVE
TUSTIN, CA
ZIP 92780
Phone: (310) 505-7717
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OC LIGHT HOUSE is a student in an organized health care education training program in Tustin, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. OC LIGHT HOUSE NPI is 1376191148. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

150 S PROSPECT AVE
TUSTIN, CA
ZIP 92780-617
Phone: (310) 505-7717

The provider's authorized official is Maria Christina Eyssallenne .
The authorized official title is Managing Member and has the following contact phone number (310) 505-7717.

The enumeration date for this NPI number is 8/26/2019 and was last updated on 8/26/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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