SHORE LIGHT BEHAVIORAL HEALTH LLC NPI 1114723616

NPI Information

  • NPI: 1114723616
  • Provider Name: SHORE LIGHT BEHAVIORAL HEALTH LLC
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Organization
  • Address: 411 CALLE MACHO
    SAN CLEMENTE, CA
    ZIP 92673
  • Phone: (888) 486-6717

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NPI Details

SHORE LIGHT BEHAVIORAL HEALTH LLC is an adult mental health clinic center in San Clemente, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. SHORE LIGHT BEHAVIORAL HEALTH LLC NPI is 1114723616. The provider is registered as an organization entity type.

The provider's business location address is:

411 CALLE MACHO
SAN CLEMENTE, CA
ZIP 92673-035
Phone: (888) 486-6717

The provider's authorized official is Stephen Vanhooser .
The authorized official title is Director Of Compliance and has the following contact phone number (949) 750-2014.

The enumeration date for this NPI number is 2/24/2025 and was last updated on 2/24/2025.

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
1261QM0850XClinic/CenterAdult Mental HealthYes

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: 3/30/2025

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