Healthcare Provider Details

I. General information

NPI: 1699685941
Provider Name (Legal Business Name): LAGUNA THERAPY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23291 MILL CREEK DR STE 100
LAGUNA HILLS CA
92653-1631
US

IV. Provider business mailing address

31706 COAST HWY UNIT 401
LAGUNA BEACH CA
92651-7022
US

V. Phone/Fax

Practice location:
  • Phone: 949-227-4306
  • Fax: 949-850-1050
Mailing address:
  • Phone: 949-227-4306
  • Fax: 949-850-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN TRYON
Title or Position: CMO
Credential:
Phone: 949-353-7162