Shore Light Behavioral Health LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SHORE LIGHT BEHAVIORAL HEALTH LLC

Practice address

25542 Rhoda Dr
Mission Viejo, CA 92691-4669

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 1114723616
  NPD tax ID
• Shore Light Behavioral Health LLC

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

Practitioners 1

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

• Christian Robert Small, MD

  • Psychiatry Physician
  • Escondido, CA
  • NPI 1740546209
  NPD (past)

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": "1902602402",
    "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": "25542 RHODA DR",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926914669",
            "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": []
}

• Jamileh Taj Shirali, DDS , DMD
• Camellia Shoapour, MD
• Hossein Shokri, PT, DPT
• Sholly Nursing Inc
• Sholly Nursing Inc
• Mohammed Shreiba, MD
• Joshua Shrivastava, MA, PTA, ATC, CSCS
• Shruti M Ariza MD Inc
• Shuttle Care LLC
• Siamak Veshkini D.M.D. a Professional Corporation

• Adult Mental Health Clinic/Center in Mission Viejo, CA
• Providers in Mission Viejo, 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.