Individual provider Active NPI

Angela Denise Young

  • Family Nurse Practitioner
  • Cypress, CA
National Provider Identifier
1720620834
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021063 Issued in CA
Practice address
5757 Plaza Dr
Cypress, CA 90630-5000
Phone
(804) 661-6494
NPI assigned
Oct 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001178273 VA
Family Nurse Practitioner 363LF0000X 95021063 CA Primary

Addresses

Primary practice location

5757 Plaza Dr
Cypress, CA 90630-5000

Mailing address

5757 Plaza Dr
Cypress, CA 90630-5000

Other practice location 1

5757 Plaza Dr
Cypress, CA 90630-5000
Phone (804) 355-9800

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
I20240207001896 CA Practitioner - Nurse Practitioner 0941634547 Reassigns benefits to 1 organization

National Provider Directory

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

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": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1720620834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 PLAZA DR",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 PLAZA DR",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305000",
            "telephone_number": "804-661-6494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5757 Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "CA",
            "postal_code": "906305000",
            "country_code": "US",
            "telephone_number": "804-355-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ANGELA",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001178273",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, CA

Sources for this page

Verify at the official NPI Registry.