Individual provider Active NPI

James Theadore Yarnall, CADC II

  • Adult Companion
  • Modesto, CA
National Provider Identifier
1619238375
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
License
AII053610318 Issued in CA
Practice address
800 Scenic Dr BLDG B
Modesto, CA 95350-6131
Phone
(408) 390-3961
Fax
(209) 558-4339
NPI assigned
May 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Y1002121424 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X AII053610318 CA
Technician 374700000X Y1002121424 CA
Adult Companion 372600000X AII053610318 CA Primary

Addresses

Primary practice location

800 Scenic Dr BLDG B
Modesto, CA 95350-6131

Mailing address

800 Scenic Dr BLDG B
Modesto, CA 95350-6131
Phone (408) 390-3961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AII053610318CAMDAddiction (Substance Use Disorder) Counselor
Y1002121424CAMDTechnician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Stanislaus CurrentSince Jun 1, 2025 Accepting new patients
Medmark Treatment Centers - Stockton, Inc. Past Accepting new patients

Locations

800 Scenic Dr
Bldg B
Modesto, CA 95350
Phone (209) 525-6101

Organizations & group practices 2

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": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1619238375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR BLDG B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "408-390-3961",
            "fax_number": "209-558-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR BLDG B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "408-390-3961",
            "fax_number": "209-558-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARNALL",
        "first_name": "JAMES",
        "middle_name": "THEADORE",
        "credential": "CADC II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-30",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "Y1002121424",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "AII053610318",
            "primary": false
        },
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "CA",
            "license": "Y1002121424",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "CA",
            "license": "AII053610318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.