Shanetra L Young, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

81202 Issued in CA

Practice address

1303 Avocado Ave Ste 120
Newport Beach, CA 92660-7840

Phone

(949) 386-9794

NPI assigned

Aug 24, 2022

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1184343907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 AVOCADO AVE STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607840",
            "telephone_number": "949-386-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 AVOCADO AVE STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607840",
            "telephone_number": "949-386-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SHANETRA",
        "middle_name": "L",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "81202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "81202",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Www.palpationmassagetherapy.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1303 Avocado Ave Ste 120",
            "city": "Newport Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926607840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Koji Yoshizawa, DC
• Harry Mark Young
• Janice S Young, M.D.
• Marshall Young, D.D.S.
• Sarah Kristine Alcaide Young, NP
• Janet Youngblood
• Chien San Yu, M.D.
• Jeehah Yu, ND
• John Jung-San Yu, MD
• Melissa Beth Yu, MD

• Massage Therapist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.