Individual provider Active NPI

Jeneba Sylvia Young

  • Marriage & Family Therapist
  • Chino, CA
National Provider Identifier
1215596382
Registry record updated Mar 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
138611 Issued in CA
Practice address
15733 Begonia Ave
Chino, CA 91708-8866
Phone
(408) 375-3776
NPI assigned
Jun 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 121338 CA
Case Manager/Care Coordinator 171M00000X
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 138611 CA Primary

Addresses

Primary practice location

15733 Begonia Ave
Chino, CA 91708-8866

Mailing address

16321 Main St Ste 130-133
Chino, CA 91708-9631
Phone (408) 375-3776

Other practice location 1

1611 S Pacific Coast Hwy Ste 307
Redondo Beach, CA 90277-5614
Phone (424) 226-6172

Other practice location 2

12099 W Washington Blvd
Los Angeles, CA 90066-5882
Phone (818) 267-2681 ext. 40837

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

State licenses

LicenseStateTypeSpecialty
121338CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740787200000",
    "number": "1215596382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16321 MAIN ST STE 130-133",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917089631",
            "telephone_number": "408-375-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15733 BEGONIA AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917088866",
            "telephone_number": "408-375-3776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 S Pacific Coast Hwy Ste 307",
            "address_purpose": "LOCATION",
            "city": "Redondo Beach",
            "state": "CA",
            "postal_code": "902775614",
            "country_code": "US",
            "telephone_number": "424-226-6172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12099 W Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900665882",
            "country_code": "US",
            "telephone_number": "818-267-2681 x40837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JENEBA",
        "middle_name": "SYLVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2025-03-01",
        "certification_date": "2025-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "121338",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2025; 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.