Healthcare Provider Details

I. General information

NPI: 1174399935
Provider Name (Legal Business Name): JUBILEE MENTAL HEALTH GROUP, A PROFESSIONAL NURSING ORGANIZATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15615 ALTON PKWY STE 450
IRVINE CA
92618-3308
US

IV. Provider business mailing address

15615 ALTON PKWY STE 450
IRVINE CA
92618-3308
US

V. Phone/Fax

Practice location:
  • Phone: 949-228-9607
  • Fax: 714-202-8858
Mailing address:
  • Phone: 949-228-9607
  • Fax: 714-202-8858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN WESLEY LU
Title or Position: PRESIDENT
Credential: PMHNP
Phone: 949-228-9607