Individual provider Active NPI

Patricia Janean Young, M.A.

  • Speech-Language Pathologist
  • Temecula, CA
National Provider Identifier
1184780314
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP0048140 Issued in CA
Practice address
31935 Calle Espinosa
Temecula, CA 92592-3743
Phone
(951) 303-9422
Fax
(951) 303-9432
NPI assigned
Dec 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SP0048140 CA Primary

Addresses

Primary practice location

31935 Calle Espinosa
Temecula, CA 92592-3743

Mailing address

31935 Calle Espinosa
Temecula, CA 92592-3743
Phone (951) 303-9422

Other identifiers 2

IdentifierTypeStateIssuer
2064835MedicaidCA
GSP000570MedicaidCA

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP0048140CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Pathology Services Single Specialty Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1184780314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31935 CALLE ESPINOSA",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925923743",
            "telephone_number": "951-303-9422",
            "fax_number": "951-303-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31935 CALLE ESPINOSA",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925923743",
            "telephone_number": "951-303-9422",
            "fax_number": "951-303-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "PATRICIA",
        "middle_name": "JANEAN",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP0048140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2064835",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSP000570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.