Healthcare Provider Details

I. General information

NPI: 1386287878
Provider Name (Legal Business Name): STARLIGHT THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26940 BASELINE ST STE 106
HIGHLAND CA
92346-3182
US

IV. Provider business mailing address

26940 BASELINE ST STE 106
HIGHLAND CA
92346-3182
US

V. Phone/Fax

Practice location:
  • Phone: 909-566-3358
  • Fax: 909-757-6400
Mailing address:
  • Phone: 909-566-3358
  • Fax: 909-757-6400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC A HEINZ
Title or Position: CEO
Credential:
Phone: 909-566-3358