Individual provider Active NPI

Neil P Young, PH.D.

  • Psychologist
  • San Francisco, CA
National Provider Identifier
1548277239
Registry record updated Apr 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY5286 Issued in CA
Practice address
2504 Clay St
San Francisco, CA 94115-1811
Phone
(415) 567-8881
Fax
(415) 388-3707
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY5286 CA Primary

Addresses

Primary practice location

2504 Clay St
San Francisco, CA 94115-1811

Mailing address

1212 Lattie LN
Mill Valley, CA 94941-3408
Phone (415) 388-3707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090609000308 CA Practitioner - Clinical Psychologist 1355491507 Practice locations: Novato, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of California, San Francisco School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Novato, CA 94945
Phone (415) 567-8881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY5286CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239321600000",
    "number": "1548277239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 LATTIE LN",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413408",
            "telephone_number": "415-388-3707",
            "fax_number": "415-388-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 CLAY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151811",
            "telephone_number": "415-567-8881",
            "fax_number": "415-388-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "NEIL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2009-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY5286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.