Thomas P Young PHD NP PC

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

Legal business name

THOMAS P YOUNG PHD NP PC

Practice address

165 Rowland Way Ste 201
Novato, CA 94945-5055

Phone

(415) 895-1441

NPI assigned

Sep 13, 2019

Organization subpart

No

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

Authorized official

Name

Thomas P Young III, PHD NPNPI 1689797029

Title

Owner

Phone

(415) 755-8952

Specialties & licenses 5

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas P Young III, PHD, NP

  • Adult Health Nurse Practitioner
  • Santa Rosa, CA
  • NPI 1689797029
  NPD (past) Authorized official
• Susan Marie St Pierre, DO

  • Addiction Medicine (Preventive Medicine) Physician
  • Novato, CA
  • NPI 1720076458
  NPD (past)

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1508416389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 HILL RD STE 14",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949474304",
            "telephone_number": "415-895-1441",
            "fax_number": "415-895-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ROWLAND WAY STE 201",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455055",
            "telephone_number": "415-895-1441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Pikes Peak Dr",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949031121",
            "country_code": "US",
            "telephone_number": "415-895-1441",
            "fax_number": "415-895-1288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THOMAS P YOUNG PHD NP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-13",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-755-8952",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PHD NP"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Registered Nurse in Novato, CA
• Providers in Novato, CA by specialty
• Addiction (Substance Use Disorder) Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.