MONTE NIDO LAKE VISTA, LLC
NPI 1609501279
Clinic/Center - Adolescent and Children Mental Health in Yorba Linda, CA

NPI Status: Active since July 19, 2022

Contact Information

17059 EL CAJON AVE
YORBA LINDA, CA
ZIP 92886
Phone: (657) 363-4633
Fax: (714) 961-6052

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  • Organization
  • Clinic/Center
  • Adolescent and Children Mental Health
  • Accepts Insurance
  • CLIA Number: 05D2303763
  • CLIA Cert. Type: Other - CONGREGATE LIVING HEALTH
  • CLIA Exp. Date: 04-29-2028

About MONTE NIDO LAKE VISTA, LLC

This page provides the complete NPI Profile along with additional information for Monte Nido Lake Vista, Llc, a provider established in Yorba Linda, California operating as a Clinic/center, focusing in adolescent and children mental health . The healthcare provider is registered in the NPI registry with number 1609501279 assigned on July 2022. The practitioner's primary taxonomy code is 261QM0855X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Mr. Mike Bagley (Chief Financial Officer)

NPI
1609501279
Provider Name
MONTE NIDO LAKE VISTA, LLC
Entity Type
Organization
Location Address
17059 EL CAJON AVE YORBA LINDA, CA 92886
Location Phone
(657) 363-4633
Location Fax
(714) 961-6052
Mailing Address
6100 SW 76TH ST SOUTH MIAMI, FL 33143
Mailing Phone
(305) 663-1876
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-19-2022
Last Update Date
07-19-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Adolescent and Children Mental Health

Taxonomy Code
261QM0855X
Type
Ambulatory Health Care Facilities
Taxonomy Description
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • KP OR Bronze 6000 - EPO
  • KP OR Bronze HSA 7100 - EPO
  • KP OR Gold 0 - EPO
  • KP OR Gold 1750 - EPO
  • KP OR Silver 3000 - EPO
  • KP OR Silver 4000 - EPO
  • KP Oregon Standard Bronze Plan - EPO
  • KP Oregon Standard Gold Plan - EPO
  • KP Oregon Standard Silver Plan - EPO
  • KP OR Family Dental - $100 Ded - EPO
  • KP OR Family Dental - $1000 - EPO
  • KP OR Family Dental - $1000/$50 Ded - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. MIKE BAGLEY

Authorized Official Title
CHIEF FINANCIAL OFFICER
Authorized Official Phone
(305) 663-1876

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2303763
Facility Type
Other - CONGREGATE LIVING HEALTH
Certificate Effective Date
April 30, 2026
Certificate Expiration Date
April 29, 2028
Laboratory Director
MOLLY M. PERLMAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Monte Nido Lake Vista, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1609501279, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
0
Doubled → 0
Pos 4
9
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
0
Unchanged
Pos 7
1
Doubled → 2
Pos 8
2
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 5 → 10 → 1 1 → 2 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 0 + 9 + 1 + 0 + 0 + 2 + 2 + 1 + 4 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1609501279.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609501279, enumerated as an "organization" on July 19, 2022.

The provider is located at 17059 EL CAJON AVE YORBA LINDA, CA 92886 and the phone number is (657) 363-4633.

Clinic/Center with taxonomy code 261QM0855X and a focus in Adolescent and Children Mental Health.

The provider might be accepting Accepts: Kaiser Permanente. Please consult your insurance carrier or call the provider to verify.