Healthcare Provider Details

I. General information

NPI: 1497601074
Provider Name (Legal Business Name): LIGHTHOUSE BEHAVIORAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41593 WINCHESTER RD STE 200-694
TEMECULA CA
92590-4860
US

IV. Provider business mailing address

39198 HALF MOON CIR
MURRIETA CA
92563-2823
US

V. Phone/Fax

Practice location:
  • Phone: 951-216-3330
  • Fax:
Mailing address:
  • Phone: 909-938-4785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: PIERRE BAQUERO
Title or Position: CEO
Credential:
Phone: 909-938-4785