Individual provider Active NPI

Yewande Noah, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1508510546
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95026261 Issued in CA
Practice address
1245 S Winchester Blvd Ste 110
San Jose, CA 95128-3908
Phone
(925) 282-1778
NPI assigned
Feb 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 95170547 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61486087 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95026261 CA Primary

Addresses

Primary practice location

1245 S Winchester Blvd Ste 110
San Jose, CA 95128-3908

Mailing address

1245 S Winchester Blvd Ste 110
San Jose, CA 95128-3908
Phone (925) 282-1778

Other practice location 1

4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone (206) 987-2000

Other practice location 2

3800 Coolidge Ave
Oakland, CA 94602-3311
Phone (510) 482-2244 ext. 5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240124002856 WA Practitioner - Nurse Practitioner 3375996523 Reassigns benefits to 1 organization
I20250925001816 CA Practitioner - Nurse Practitioner 3375996523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

1245 S Winchester Blvd
Suite 110
San Jose, CA 95128-3908
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95170547CAMDChild & Adolescent Psychiatric/Mental Health Registered Nurse
95026261CAMDPsychiatric/Mental Health Nurse Practitioner
AP61486087WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Childrens Hospital CurrentSince Jan 1, 2024 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients
Pacific Coast Psychiatric Associates Inc CurrentSince Sep 11, 2025 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

1480 64th St
Ste 150
Emeryville, CA 94608
Phone (415) 296-5292

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

1245 S Winchester Blvd
Ste 110
San Jose, CA 95128
Phone (415) 296-5299

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.yewandenoah@148377.advancedmd-direct.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508510546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S WINCHESTER BLVD STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283908",
            "telephone_number": "925-282-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 S WINCHESTER BLVD STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283908",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 Coolidge Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946023311",
            "country_code": "US",
            "telephone_number": "510-482-2244 x5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOAH",
        "first_name": "YEWANDE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "95170547",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61486087",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95026261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.