Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Monte Nido Lake Vista, LLC

Organization Adolescent and Children Mental Health Clinic/Center · NPI 1780105551

Monte Nido Lake Vista, LLC is an Adolescent and Children Mental Health Clinic/Center in Agoura Hills, California. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

29470 Lake Vista Dr
Agoura Hills, CA 91301-2818
Phone: (747) 212-5021
Fax: (818) 575-7327
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adolescent and Children Mental Health Clinic/Center (primary) Taxonomy 261QM0855X

Record details

NPI number1780105551
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMonte Nido Lake Vista, LLC
Authorized official Mike Bagley — Chief Financial Officer · (305) 663-1876
Other names Clementine Malibu Lake; Clementine Malibu Lake
NPI enumeratedJuly 3, 2017
Last updated in NPPESMay 27, 2020
Certification dateMay 27, 2020
Mailing address6100 Sw 76th St, South Miami, FL 33143-5002

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