Active NPI
Justin C Young, M.D.
- Psychiatry Physician
- Menlo Park, CA
National Provider Identifier
1437356078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A92560
- Practice address
- 825 Oak Grove Ave
Suite A201
Menlo Park, CA 94025-4434 - Phone
- (650) 838-9888
- NPI assigned
- Jun 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A92560 | CA | Primary |
Addresses
Primary practice location
825 Oak Grove Ave
Suite A201
Menlo Park, CA 94025-4434
Mailing address
825 Oak Grove Ave
Suite A201
Menlo Park, CA 94025
Phone (650) 838-9888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 16, 2015 through Nov 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 92560 | CA | MD | Marriage & Family Therapist |
| A92560 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217808000000",
"number": "1437356078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 OAK GROVE AVE",
"address_2": "SUITE A201",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "94025",
"telephone_number": "650-838-9888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 OAK GROVE AVE",
"address_2": "SUITE A201",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254434",
"telephone_number": "650-838-9888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "JUSTIN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-28",
"last_updated": "2008-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A92560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menlo Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.