Active NPI
Juinchen Preston Young, PHARMD
- Pharmacist
- Mill Valley, CA
National Provider Identifier
1376178418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH82251
- Practice address
- 1 Camino Alto
Mill Valley, CA 94941-2974 - Phone
- (310) 971-7055
- NPI assigned
- Mar 10, 2020
- Last updated
- Dec 6, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH82251 | CA | Primary |
Addresses
Primary practice location
1 Camino Alto
Mill Valley, CA 94941-2974
Mailing address
521 Carlson Ave Unit 316
Rohnert Park, CA 94928-2880
Phone (310) 971-7055
Other practice location 1
6340 Commerce Blvd
Rohnert Park, CA 94928-2404
Phone (707) 585-5980
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH82251 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1376178418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "521 CARLSON AVE UNIT 316",
"city": "ROHNERT PARK",
"state": "CA",
"postal_code": "949282880",
"telephone_number": "310-971-7055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CAMINO ALTO",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949412974",
"telephone_number": "310-971-7055"
}
],
"practiceLocations": [
{
"address_1": "6340 Commerce Blvd",
"address_purpose": "LOCATION",
"city": "Rohnert Park",
"state": "CA",
"postal_code": "949282404",
"country_code": "US",
"telephone_number": "707-585-5980",
"fax_number": "707-585-5984",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUNG",
"first_name": "JUINCHEN",
"middle_name": "PRESTON",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-10",
"last_updated": "2021-12-06",
"certification_date": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH82251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mill Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.