Shore Light Behavioral Health LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SHORE LIGHT BEHAVIORAL HEALTH LLC

Practice address

411 Calle Macho
San Clemente, CA 92673-3035

Phone

(888) 486-6717

NPI assigned

Feb 24, 2025

Organization subpart

No

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

Authorized official

Name

Stephen Vanhooser

Title

Director of Compliance

Phone

(949) 750-2014

Specialties & licenses 1

Addresses

Tax ID family

Shore Light Behavioral Health LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Shore Light Behavioral Health LLC

  • Adult Mental Health Clinic/Center
  • San Clemente, CA
  • NPI 1518763028
  NPD tax ID
• Shore Light Behavioral Health LLC

  • Adult Mental Health Clinic/Center
  • Mission Viejo, CA
  • NPI 1902602402
  NPD tax ID

Locations

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1114723616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 E 1ST AVE STE 200",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802065636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CALLE MACHO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926733035",
            "telephone_number": "888-486-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE LIGHT BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "VANHOOSER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "949-750-2014"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aravinda Kumar Shetty
• Dalton Shevlin
• Cynthia Shoga, D.C
• Sara Shokouhi, MD
• Carolyn Dawn Shook, MFT
• Shore Light Behavioral Health LLC
• Shorecliffs Medical Group Inc
• Shreya Health of California
• Shreya Health of California, Inc.
• Lisa Shue, MD

• Adult Mental Health Clinic/Center in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.