Healthcare Provider Details

I. General information

NPI: 1497253561
Provider Name (Legal Business Name): SBT HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25819 JEFFERSON AVE STE 110-120
MURRIETA CA
92562-6964
US

IV. Provider business mailing address

23905 CLINTON KEITH RD # 114-535
WILDOMAR CA
92595-7897
US

V. Phone/Fax

Practice location:
  • Phone: 951-813-2597
  • Fax:
Mailing address:
  • Phone: 951-813-2597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERICH PORTIGAL
Title or Position: VICE PRESI
Credential:
Phone: 951-813-2597