VITALIY SHAULOV, MD, INC (NPI# 1720268980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720268980 |
| Entity Type | Organization |
| Organization Name | VITALIY SHAULOV, MD, INC |
| Practice Address |
25411 Cabot Rd Suite 116 Laguna Hills CA 92653-5520 |
| Mailing Address |
28895 El Apajo Laguna Niguel CA 92677-7616 |
| Practice Telephone | 9493097903 |
| Practice Fax Number | 9497165243 |
| Mailing Telephone | 9493097903 |
| Mailing Fax Number | 9497165243 |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-05 |
| Authorized Official Name | MR. VITALIY SHAULOV (PRESIDENT) |
| Authorized Official Telephone | 9493097903 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | A775921 | CA | Behavioral Health & Social Service Providers |
| Street Address |
25411 CABOT RD SUITE 116 |
| City | LAGUNA HILLS |
| State | CA |
| Zip Code | 92653-5520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972592020 | Sandra Jorgensen | Psychologist | 25411 Cabot Rd, Suite 107, Laguna Hills, CA 92653-5520 | 2005-10-20 |
| 1881234540 | Leonel Martinez | Behavior Technician | 25411 Cabot Rd, Laguna Hills, CA 92653-5520 | 2020-01-10 |
| 1265679237 | Sylvia B. Lane | Social Worker | 25411 Cabot Rd, Suite 107, Laguna Hills, CA 92653-5520 | 2009-01-13 |
| 1144466384 | Kelly Portnoff, M.d., Inc. | Internal Medicine | 25411 Cabot Rd, Suite 109, Laguna Hills, CA 92653-5520 | 2008-12-17 |
| 1124200084 | Sandra M. Klonsky | Marriage & Family Therapist | 25411 Cabot Rd, Suite 107, Laguna Hills, CA 92653-5520 | 2007-12-03 |
| 1295818565 | Gary L. Sugarman,m.d.,inc. | Clinic/Center | 25411 Cabot Rd, Suite 105, Laguna Hills, CA 92653-5520 | 2006-10-23 |
| 1942383203 | Gary Louis Sugarman | Internal Medicine | 25411 Cabot Rd, Suite 105, Laguna Hills, CA 92653-5520 | 2006-10-23 |
| 1902999576 | Schahrokh Fatehi | Dentist | 25411 Cabot Rd, Suite #108, Laguna Hills, CA 92653-5520 | 2006-10-02 |
| 1801987037 | Arthritis Center of Southern Orange County | Specialist | 25411 Cabot Rd, Suite 112, Laguna Hills, CA 92653-5520 | 2006-09-26 |
| 1629179536 | Mark Jason | Specialist | 25411 Cabot Rd, Suite 112, Laguna Hills, CA 92653-5520 | 2006-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
| 1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
| 1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
| 1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
| 1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
| 1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
| 1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
| 1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
| Find all providers in zip 92653 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033720818 | Michelle T Volz | Marriage & Family Therapist | 24881 Alicia Pkwy # E-223, Laguna Hills, CA 92653-4617 | 2020-08-13 |
| 1124668009 | Casey Rath | Marriage & Family Therapist | 23461 S Pointe Dr Ste 340, Laguna Hills, CA 92653-1523 | 2020-01-08 |
| 1407492242 | Elsa Valdes | Marriage & Family Therapist | 23461 S Pointe Dr Ste 190, Laguna Hills, CA 92653-1538 | 2019-11-26 |
| 1780228874 | Young H Choi | Marriage & Family Therapist | 23441 S Pointe Dr Ste 325, Laguna Hills, CA 92653-1549 | 2019-10-31 |
| 1164912481 | Anna Marie Jones | Marriage & Family Therapist | 25401 Cabot Rd Ste 217, Laguna Hills, CA 92653-5514 | 2018-05-11 |
| 1447787205 | Danielle Marie Norgaard | Marriage & Family Therapist | 23272 Mill Creek Dr Ste 360, Laguna Hills, CA 92653-1681 | 2017-05-11 |
| 1902266745 | Hala R. Elshiwick | Marriage & Family Therapist | 23181 La Cadena Dr Ste 104, Laguna Hills, CA 92653-1479 | 2016-03-04 |
| 1114386547 | Grace Eun Lee | Marriage & Family Therapist | 24941 Overland Dr, Laguna Hills, CA 92653-5077 | 2016-02-12 |
| 1114316841 | April Dona | Marriage & Family Therapist | 23421 S Pointe Dr Ste 275, Laguna Hills, CA 92653-1555 | 2015-01-19 |
| 1619371101 | Julie Howard | Marriage & Family Therapist | 24362 Berrendo, Apt 6, Laguna Hills, CA 92656-3167 | 2014-10-13 |
| Find all providers in LAGUNA HILLS | ||||
| City | LAGUNA HILLS |
| Zip Code | 92653 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.