Rachel Youngblom

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

4661641 Issued in AZ

Practice address

4501 N 22ND St
Phoenix, AZ 85016-0600

Phone

(602) 237-6653

NPI assigned

Dec 18, 2015

Last updated

Dec 18, 2015By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1164887014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13549 W CALAVAR RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853798323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 N 22ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160600",
            "telephone_number": "602-237-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOM",
        "first_name": "RACHEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "AZ",
            "license": "4661641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott J Young, PA
• Sheryl Ann Young, RN
• Thomas Young, D.O.
• Weston Glade Young, D.O.
• Joshua Youngberg, DPT
• Mary Youngblood
• Reginald Younger Jr., MFT INTERN
• Steven Younger, MD
• Tina L. Younger, MD
• Chelsea Eileen Youngs, M.S

• School Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• School Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.