Nelsen William Young, SFIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

206 Neptune Street
San Diego, CA 92155-5136

Phone

(619) 537-3371

NPI assigned

Dec 17, 2017

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1513468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1174039978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 CAMINO DE LA REINA APT 360",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083270",
            "telephone_number": "661-718-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 NEPTUNE STREET",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921555136",
            "telephone_number": "619-537-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "NELSEN",
        "middle_name": "WILLIAM",
        "credential": "SFIDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-17",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Young
• Maile Ann Young, MD
• Megan D Young, MSW, ACSW
• Michael Young
• Nathan Christopher Young
• Nicole Young, PSY.D.
• Nikki Young
• Olivia Grace Young
• Patricia Young, R.N.
• Patricia Beth Young, LCSW

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.