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General NPI Number Information
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NPI Number | 1053202028
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Entity Type | Organization
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Legal Business Name | SHINE PSYCHIATRY PROFESSIONAL NURSING CORP.
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 14451 CHAMBERS RD STE 110
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City | TUSTIN
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State | CA
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Zip | 92780-6973
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Country | US
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Telephone | 650-507-4826
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Fax | 650-396-7917
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Provider Business Mailing Address
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Address Line | 1054 WINGFOOT ST
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City | PLACENTIA
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State | CA
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Zip | 92870-4444
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Country | US
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Telephone | 714-337-8020
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Fax | 650-396-7917
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Authorized Official
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Title or Position | CEO
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Name | SAHIL GIRISH MEHTA
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Credential | PMHNP
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Telephone | 714-337-8020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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