Individual provider Active NPI

Sahil Mehta

  • Psychiatric/Mental Health Nurse Practitioner
  • Irvine, CA
National Provider Identifier
1215708086
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95028592 Issued in CA
Practice address
2102 Business Center Dr Ste 250
Irvine, CA 92612-1001
Phone
(562) 541-8950
NPI assigned
Jan 11, 2024
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95028592 CA Primary

Addresses

Primary practice location

2102 Business Center Dr Ste 250
Irvine, CA 92612-1001

Mailing address

211 S State College Blvd # 10099
Anaheim, CA 92806-4116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240531003844 CA Practitioner - Nurse Practitioner 7315489606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Psychiatry Professional Nursing Corp. CurrentSince Jul 13, 2025 Accepting new patients

Locations

14451 Chambers Rd
Ste 110
Tustin, CA 92780
Phone (650) 507-4826

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1215708086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S STATE COLLEGE BLVD # 10099",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928064116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 BUSINESS CENTER DR STE 250",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121001",
            "telephone_number": "562-541-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "SAHIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95028592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.