Individual provider Active NPI

Clydeisha Younger, CPT 1

  • Phlebotomy Technician
  • Fairfield, CA
National Provider Identifier
1699608364
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
CPT-02287545 Issued in CA
Practice address
1652 W Texas St Ste 121
Fairfield, CA 94533-5952
Phone
(916) 915-4669
NPI assigned
Jun 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X CPT-02287545 CA Primary

Addresses

Primary practice location

1652 W Texas St Ste 121
Fairfield, CA 94533-5952

Mailing address

1652 W Texas St Ste 121
Fairfield, CA 94533-5952
Phone (916) 915-4669

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CPT-02287545CAMDPhlebotomy Technician

NPI Registry JSON

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

{
    "created_epoch": "1780531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1699608364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 W TEXAS ST STE 121",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335952",
            "telephone_number": "916-915-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 W TEXAS ST STE 121",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335952",
            "telephone_number": "916-915-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGER",
        "first_name": "CLYDEISHA",
        "credential": "CPT 1",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-04",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "CA",
            "license": "CPT-02287545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.