Shayne Ann Vitemb, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFC#51827 Issued in CA

Practice address

302 W Grand Ave
Suite 7
El Segundo, CA 90245-3700

Phone

(310) 227-0201

Fax

(310) 726-1030

NPI assigned

Mar 5, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1104167832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W GRAND AVE",
            "address_2": "SUITE 7",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453700",
            "telephone_number": "310-227-0201",
            "fax_number": "310-726-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W GRAND AVE",
            "address_2": "SUITE 7",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453700",
            "telephone_number": "310-227-0201",
            "fax_number": "310-726-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITEMB",
        "first_name": "SHAYNE",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC#51827",
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "CA",
            "license": "MFC#51827",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamilya Viravong
• Aryana N. Viruet
• Wendy Vitalich
• Tsanaya Vitatoe
• Rebekah Vitello
• Jeanie Vo
• Jesmin Vo
• Jevin Vo
• Katelyn A Vo
• Natalie Vo

• Mental Health Counselor in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.