Active NPI
Yeonsoo Julie Young, PA-C
- Physician Assistant
- Riverside, CA
National Provider Identifier
1649813239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 58309
- Practice address
- 5885 Brockton Ave
Riverside, CA 92506-1863 - Phone
- (800) 270-5016
- NPI assigned
- Oct 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 58309 | CA | Primary |
Addresses
Primary practice location
5885 Brockton Ave
Riverside, CA 92506-1863
Mailing address
15025 Hunters Gate Cir
Chino Hills, CA 91709-6218
Phone (714) 673-1290
Other practice location 1
234 E Badillo St
Covina, CA 91723-2115
Phone (626) 915-9992
Other practice location 2
15025 Hunters Gate Cir
Chino Hills, CA 91709-6218
Phone (714) 673-1290
Other names 1
- Yeonsoo Julie Lee
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58309 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739404800000",
"number": "1649813239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15025 HUNTERS GATE CIR",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917096218",
"telephone_number": "714-673-1290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5885 BROCKTON AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925061863",
"telephone_number": "800-270-5016"
}
],
"practiceLocations": [
{
"address_1": "234 E Badillo St",
"address_purpose": "LOCATION",
"city": "Covina",
"state": "CA",
"postal_code": "917232115",
"country_code": "US",
"telephone_number": "626-915-9992",
"fax_number": "626-915-6108",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15025 Hunters Gate Cir",
"address_purpose": "LOCATION",
"city": "Chino Hills",
"state": "CA",
"postal_code": "917096218",
"country_code": "US",
"telephone_number": "714-673-1290",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUNG",
"first_name": "YEONSOO",
"middle_name": "JULIE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-25",
"last_updated": "2025-02-13",
"certification_date": "2025-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "58309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "YEONSOO",
"last_name": "LEE",
"middle_name": "JULIE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.