Youssef Elmanawy, PHD. LAADC.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1525 Union Ave
Fairfield, CA 94533-5049

Phone

(707) 435-1804

NPI assigned

Mar 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1245798016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 WAXWING PL",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956167526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 UNION AVE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335049",
            "telephone_number": "707-435-1804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Paul Dr",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949032023",
            "country_code": "US",
            "telephone_number": "415-446-1924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELMANAWY",
        "first_name": "YOUSSEF",
        "credential": "PHD. LAADC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-11",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "LCI04511115",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "LCI04511115",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darrell Lamont Ellingberg Jr.
• Joshua Thomas Ellington
• Leland Dean Elliott, RBT
• Billy Frank Ellis Jr.
• Mark H Ellis, MD
• Joevone Elster Sr., CADC-II
• Rianna Eltagonde
• Emergency and Acute Care Medical Corporation
• Emeritus Corporation
• Kara Emery, PSY.D.

• Student in an Organized Health Care Education/Training Program in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.