Monte Nido Lake Vista, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

MONTE NIDO LAKE VISTA, LLC

Doing business as

Monte Nido East Bay

Practice address

1776 Ivanhoe Ave
Lafayette, CA 94549-1954

Phone

(305) 663-1876

Fax

(786) 359-4485

NPI assigned

May 27, 2020

Organization subpart

Yes

Parent organization

MONTE NIDO LAKE VISTA, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jason Schulz

Title

Chief Financial Officer

Phone

(305) 663-1876

Specialties & licenses 1

Addresses

Other names 1

• Monte Nido East Bay Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Monte Nido Lake Vista LLC4 organizations share this tax ID, including this one

Part of

Monte Nido Lake Vista LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Monte Nido Lake Vista, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Yorba Linda, CA
  • NPI 1609501279
  NPD tax ID
• Monte Nido Lake Vista, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Agoura Hills, CA
  • NPI 1730357930
  NPD tax ID
• Monte Nido Lake Vista, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Agoura Hills, CA
  • NPI 1780105551
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1053934984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SW 76TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435002",
            "telephone_number": "305-663-1876",
            "fax_number": "786-359-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 IVANHOE AVE",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945491954",
            "telephone_number": "305-663-1876",
            "fax_number": "786-359-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTE NIDO LAKE VISTA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTE NIDO LAKE VISTA, LLC",
        "enumeration_date": "2020-05-27",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "SCHULZ",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "305-663-1876"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monte Nido East Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stefan Mitosinka
• Modesto Radiological Medical Group
• Calley Moita
• Herbert Robert Monroe, O.D.
• Wendy Hanai Montano
• Ramon Jesus Montes de Oca Mundo
• Ernestine Ruth Montgomery
• Erick Montoya
• Britny Moore
• Travis Moore, DPT

• Mental Illness Community Based Residential Treatment Facility in Lafayette, CA
• Providers in Lafayette, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.