Organization
LIVED EXPERIENCES
Active
Other names
Lived Experiences
Organization subpart
No
Provider details
NPI number
Authorized official
OSCARIN ORTEGA (CEO)
(619) 368-3790
Entity
Organization
Contact information
Practice address
610 N REDONDO DR STE A, OCEANSIDE, CA 92057-4313
(442) 266-2083
Mailing address
610 N REDONDO DR STE A, OCEANSIDE, CA 92057-4313
(442) 266-2083
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251T00000X
PACE Provider Organization
—
—
251V00000X
Voluntary or Charitable Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
332U00000X
Home Delivered Meals
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BL-1270739
CITY BUSINESS LICENSE NUMBER
CA
Enumeration date
02/06/2023
Last updated
02/24/2026
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