Jennifer S Young DO, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JENNIFER S YOUNG DO, INC.

Practice address

558 N Ventu Park Rd
Suite a
Thousand Oaks, CA 91320-2718

Phone

(805) 498-8265

Fax

(805) 498-3689

NPI assigned

Nov 12, 2014

Organization subpart

No

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

Authorized official

Name

Jennifer Susan Young, DONPI 1225359839

Title

Owner

Phone

(626) 548-8822

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer S Young, DO

  • Family Medicine Physician
  • Thousand Oaks, CA
  • NPI 1225359839
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1235535659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 N VENTU PARK RD",
            "address_2": "SUITE A",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202718",
            "telephone_number": "805-498-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 N VENTU PARK RD",
            "address_2": "SUITE A",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202718",
            "telephone_number": "805-498-8265",
            "fax_number": "805-498-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER S YOUNG DO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-548-8822",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.