Individual provider Active NPI

Sarah Young Dejesus, N.P

  • Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1689063273
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95001651 Issued in CA
Practice address
3762 Tibbetts St
Riverside, CA 92506-2605
Phone
(949) 414-7246
Fax
(949) 757-3846
NPI assigned
Jan 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95001651 CA Primary

Addresses

Primary practice location

3762 Tibbetts St
Riverside, CA 92506-2605

Mailing address

3762 Tibbetts St
Riverside, CA 92506-2605
Phone (949) 414-7246

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200417002438 CA Practitioner - Nurse Practitioner 0446549158 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95001651CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Spine and Pain Centers CurrentSince Mar 7, 2022 Accepting new patients

Locations

12000 Mount Vernon Ave
Grand Terrace, CA 92313
Phone 20130889955174

3657 Van Buren Blvd
Riverside, CA 92503
Phone (909) 238-7966

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

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": "1421712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1689063273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3762 TIBBETTS ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062605",
            "telephone_number": "949-414-7246",
            "fax_number": "949-757-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3762 TIBBETTS ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062605",
            "telephone_number": "949-414-7246",
            "fax_number": "949-757-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "SARAH",
        "middle_name": "YOUNG",
        "name_prefix": "Mrs.",
        "credential": "N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-20",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95001651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.