Constantine Vasilomanolakis

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

124988 Issued in CA

Practice address

36 Malaga Cove PLZ Ste 202
Palos Verdes Estates, CA 90274-6813

Phone

(562) 881-7195

NPI assigned

Aug 28, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 9, 2024 through May 9, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• JLM Psychological Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newport Beach, CA
  • NPI 1003482423
  NPD (past)

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1275089419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MALAGA COVE PLZ STE 202",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "902746813",
            "telephone_number": "562-881-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MALAGA COVE PLZ STE 202",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "902746813",
            "telephone_number": "562-881-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILOMANOLAKIS",
        "first_name": "CONSTANTINE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "124988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Titlow Inc (Sarah Bryan Therapy)
• Treasures Within Family Counseling, Inc.
• Ursula Pandey Trivedi, MPH, RD
• April Upp
• Dyan Marie Vandevelde, DMD
• Nicole Lynn Vergara
• Vitum Medical, Inc (The Collective)
• James Scott Watson, PH.D.
• We Bow Down (Throttle & Thrive)
• Brittney Wong

• Marriage & Family Therapist in Palos Verdes Estates, CA
• Providers in Palos Verdes Estates, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.

Verify at the official NPI Registry.