Individual provider Active NPI

Jeanetta Latrice Young-Yeboah

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1629873732
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
159193 Issued in CA
Practice address
1845 Business Center Dr Ste 215
San Bernardino, CA 92408-3447
Phone
(909) 562-5571
NPI assigned
Feb 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 159193 CA Primary

Addresses

Primary practice location

1845 Business Center Dr Ste 215
San Bernardino, CA 92408-3447

Mailing address

6941 Orozco Dr
Riverside, CA 92506-5583
Phone (909) 562-5571

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
I20260330001528 CA Practitioner - Marriage and Family Therapist 6800371733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1630 W Redlands Blvd
Suite J
Redlands, CA 92373-8032

PO Box
Suite 1173
Salem, UT 84653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
159193CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yeboah Marriage & Family Therapy Inc Current Accepting new patients

Organizations & group practices 1

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": "1739491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1629873732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6941 OROZCO DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925065583",
            "telephone_number": "909-562-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 BUSINESS CENTER DR STE 215",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083447",
            "telephone_number": "909-562-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG-YEBOAH",
        "first_name": "JEANETTA",
        "middle_name": "LATRICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "159193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.