Active NPI
Shyla Michelle Witthaus, FNP-BC
- Family Nurse Practitioner
- Yorba Linda, CA
National Provider Identifier
1144684499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.011227
- Practice address
- 18300 Yorba Linda Blvd
Yorba Linda, CA 92886 - Phone
- (714) 577-6000
- NPI assigned
- Apr 12, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.384423 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209.011227 | IL | Primary |
Addresses
Primary practice location
18300 Yorba Linda Blvd
Yorba Linda, CA 92886
Mailing address
39924 N Trevino LN
Antioch, IL 60002-2320
Phone (210) 326-0477
Other practice location 1
201 S Milwaukee Ave
Lake Villa, IL 60046-8551
Phone (847) 356-9009
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | switthaus1156629@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2026 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.384423 | IL | MD | Registered Nurse |
| 209.011227 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yorba Linda Family Physicians, a Medical Group, Inc. | Past | Accepting new patients |
Interoperability endpoints
- switthaus1156629@oc.providencedirect.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Yorba Linda, CA
- NPI 1295782423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1144684499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39924 N TREVINO LN",
"city": "ANTIOCH",
"state": "IL",
"postal_code": "600022320",
"telephone_number": "210-326-0477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18300 YORBA LINDA BLVD",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "92886",
"telephone_number": "714-577-6000"
}
],
"practiceLocations": [
{
"address_1": "201 S Milwaukee Ave",
"address_purpose": "LOCATION",
"city": "Lake Villa",
"state": "IL",
"postal_code": "600468551",
"country_code": "US",
"telephone_number": "847-356-9009",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WITTHAUS",
"first_name": "SHYLA",
"middle_name": "MICHELLE",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-12",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.384423",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.011227",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "switthaus1156629@oc.providencedirect.org",
"affiliation": "N",
"address_1": "1826 W Orangethorpe Ave",
"city": "Fullerton",
"state": "CA",
"country_code": "US",
"postal_code": "928334406",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Yorba Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.