Organization Active NPI

Jennifer Yang Psychologist P.C.

  • Psychologist
  • Santa Rosa, CA
National Provider Identifier
1205612322
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
JENNIFER YANG PSYCHOLOGIST P.C.
Practice address
613 4TH St Ste 208
Santa Rosa, CA 95404-4457
Phone
(707) 302-8839
NPI assigned
Sep 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Dr. Jennifer Yang, PSY.D.NPI 1841731346
Title
President
Phone
(707) 302-8839

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

613 4TH St Ste 208
Santa Rosa, CA 95404-4457

Mailing address

613 4TH St Ste 208
Santa Rosa, CA 95404-4457

National Provider Directory

National Provider Directory

Locations

613 4th St
Ste 208
Santa Rosa, CA 95404
Phone (707) 302-8839

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1205612322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 4TH ST STE 208",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 4TH ST STE 208",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044457",
            "telephone_number": "707-302-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER YANG PSYCHOLOGIST P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-302-8839",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.