Individual provider Active NPI

Benita Rosalyn Young, PH.D.

  • Marriage & Family Therapist
  • Sherman Oaks, CA
National Provider Identifier
1386855211
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC36983 Issued in CA
Practice address
13949 Ventura Blvd
Suite 210
Sherman Oaks, CA 91423-3584
Phone
(818) 999-7719
Fax
(818) 990-1702
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC36983 CA Primary

Addresses

Primary practice location

13949 Ventura Blvd
Suite 210
Sherman Oaks, CA 91423-3584

Mailing address

13949 Ventura Blvd
Suite 210
Sherman Oaks, CA 91423-3584
Phone (818) 999-7719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Jul 31, 2024 through Jul 31, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFC36983CAMDMarriage & Family Therapist
36983CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386855211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13949 VENTURA BLVD",
            "address_2": "SUITE 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914233584",
            "telephone_number": "818-999-7719",
            "fax_number": "818-990-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13949 VENTURA BLVD",
            "address_2": "SUITE 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914233584",
            "telephone_number": "818-999-7719",
            "fax_number": "818-990-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BENITA",
        "middle_name": "ROSALYN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC36983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.