Yejide Ann Nelson-Glenn, TEACHING CREDENTIAL

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2659 Heather St
Lodi, CA 95242-9777

Phone

(707) 486-9368

NPI assigned

Oct 31, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1619799434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 DELAWARE AVE # 3776",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198064743",
            "telephone_number": "707-486-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 HEATHER ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952429777",
            "telephone_number": "707-486-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON-GLENN",
        "first_name": "YEJIDE",
        "middle_name": "ANN",
        "credential": "TEACHING CREDENTIAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Gary Navone, M.D.
• David Allen Neal, D.D.S.
• Hannah Neal
• Alexander Johannes Nedopil, M.D.
• Lori Neely, PHARM D
• Kendra Elise Nelson
• Michelle Elizabeth Nelson, LMFT#114300
• New Family Christian Church
• Alexus Lan Ngo-Agard, MS
• Shirley Ngo

• Student in an Organized Health Care Education/Training Program in Lodi, CA
• Providers in Lodi, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.