NPIMap

Organization Active NPI

Starlight Community Services, Inc.

  • Community/Behavioral Health Agency
  • San Jose, CA
National Provider Identifier
1730352303
Registry record updated Feb 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STARLIGHT COMMUNITY SERVICES, INC.
Practice address
1885 Lundy Ave
Suite 223 and 260
San Jose, CA 95131-1888
Phone
(510) 635-9705
NPI assigned
Apr 3, 2008
Organization subpart
Yes
Parent organization
STARLIGHT ADOLESCENT CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2025

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

Authorized official

Name
Kent Dunlap
Title
President and Chief Executive Offic
Phone
(310) 221-6336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1885 Lundy Ave
Suite 223 and 260
San Jose, CA 95131-1888

Mailing address

1885 Lundy Ave
Suite 223 and 260
San Jose, CA 95131-1888
Phone (510) 635-9705

Other identifiers 2

IdentifierTypeStateIssuer
2215524OtherCASTATE CORP #
43AGOtherCASANTA CLARA CTY. MED PROV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241114000581 CA Part B Supplier - Clinic/Group Practice 9436683364 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: San Jose, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Starlight Adolescent Center14 organizations share this tax ID, including this one
Part of
Starlight Adolescent Center

Other organizations with this tax ID 13

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

View all 13

Locations

6203 San Ignacio Ave
#150
San Jose, CA 95119
Phone (669) 220-1905

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738454400000",
    "number": "1730352303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 LUNDY AVE",
            "address_2": "SUITE 223 AND 260",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311888",
            "telephone_number": "510-635-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 LUNDY AVE",
            "address_2": "SUITE 223 AND 260",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311888",
            "telephone_number": "510-635-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARLIGHT COMMUNITY SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STARLIGHT ADOLESCENT CENTER, INC.",
        "enumeration_date": "2008-04-03",
        "last_updated": "2025-02-02",
        "certification_date": "2025-02-02",
        "status": "A",
        "authorized_official_last_name": "DUNLAP",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT AND CHIEF EXECUTIVE OFFIC",
        "authorized_official_telephone_number": "310-221-6336"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CORP #",
            "identifier": "2215524",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CLARA CTY. MED PROV",
            "identifier": "43AG",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.