Individual provider Active NPI

Joanna Leigh Carson-Young, LMFT

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1083230981
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
80858 Issued in CA
Practice address
1769 Park Ave Ste 220
San Jose, CA 95126-2025
Phone
(408) 520-1486
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 80858 CA Primary

Addresses

Primary practice location

1769 Park Ave Ste 220
San Jose, CA 95126-2025

Mailing address

946 Myrtle St
San Jose, CA 95126-1225
Phone (408) 859-9631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
80858CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1083230981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 MYRTLE ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261225",
            "telephone_number": "408-859-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1769 PARK AVE STE 220",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262025",
            "telephone_number": "408-520-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON-YOUNG",
        "first_name": "JOANNA",
        "middle_name": "LEIGH",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "80858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.