Monte Nido Lake Vista, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MONTE NIDO LAKE VISTA, LLC

Practice address

17059 El Cajon Ave
Yorba Linda, CA 92886-2220

Phone

(657) 363-4633

Fax

(714) 961-6052

NPI assigned

Jul 19, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Jason Schulz

Title

Chief Financial Officer

Phone

(305) 663-1876

Specialties & licenses 1

Addresses

Other names 1

• Clementine Orange County 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

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

  • Mental Illness Community Based Residential Treatment Facility
  • Lafayette, CA
  • NPI 1053934984
  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": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1609501279",
    "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": "17059 EL CAJON AVE",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862220",
            "telephone_number": "657-363-4633",
            "fax_number": "714-961-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTE NIDO LAKE VISTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-19",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clementine Orange County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dariann Raynell Modeliste, AMFT
• Melanie Lungay Mohleji, MD
• Hoda Mojazi Amiri, MD
• John Zara Moloian, D.C.
• Negin Momtaz, DDS
• Kristoffer Petersen Monzon, PT
• Alfred Moon, M.D.
• Jennifer Morales
• Patricia Iveth Moran
• Lauren Morreale

• Adolescent and Children Mental Health Clinic/Center in Yorba Linda, CA
• Providers in Yorba Linda, CA by specialty
• Adolescent and Children Mental Health Clinic/Center 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.