Individual provider Active NPI

Rebecca Des Young

  • Occupational Therapist
  • Berkeley, CA
National Provider Identifier
1639446909
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8162 Issued in CA
Practice address
1550 Ward St
Berkeley, CA 94703-1826
Phone
(510) 334-7191
NPI assigned
Nov 30, 2011
Last updated
Sep 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8162 CA Primary

Addresses

Primary practice location

1550 Ward St
Berkeley, CA 94703-1826

Mailing address

1550 Ward St
Berkeley, CA 94703-1826
Phone (510) 644-3556

Other names 1

  • Rebecca Young Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8162CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy in Your Home - OT, PT, St Occupational Therapist CurrentSince Jul 21, 2017 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1639446909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 WARD ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947031826",
            "telephone_number": "510-644-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 WARD ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947031826",
            "telephone_number": "510-334-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "REBECCA",
        "middle_name": "DES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "8162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "YOUNG",
            "credential": "OT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.