Individual provider Active NPI

Rebecca Young, MSN, RN, CPN

  • Diabetes Educator Registered Nurse
  • Cameron Park, CA
National Provider Identifier
1265120919
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
95069321 Issued in CA
Practice address
3581 Palmer Dr Ste 201
Cameron Park, CA 95682-8237
Phone
(530) 672-7021
NPI assigned
Apr 28, 2023
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 95069321 CA Primary

Addresses

Primary practice location

3581 Palmer Dr Ste 201
Cameron Park, CA 95682-8237

Mailing address

3633 Devon Way
El Dorado Hills, CA 95762-6206

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 Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95069321CAMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1265120919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 DEVON WAY",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957626206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 PALMER DR STE 201",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828237",
            "telephone_number": "530-672-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "REBECCA",
        "credential": "MSN, RN, CPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "95069321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.