Lisa Anne Youngblood, RN NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11011940 Issued in FL

Practice address

1055 Wilshire Blvd Ste 1705
Los Angeles, CA 90017-5600

Phone

(310) 871-0670

Fax

(619) 667-0815

NPI assigned

May 27, 2006

Last updated

Feb 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Lisa Anne Catarevas Former name

Medicare fee-for-service enrollment

Enrolled in CA, FL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Segal Telepsychiatry NetworkGroup PAC ID 1951564111, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Segal Telepsychiatry Network

  • Psychoanalyst
  • Mill Valley, CA
  • NPI 1245529296
  Medicare reassignment Care Compare group NPD
• Medi Psych Services Inc

  • Child & Adolescent Psychiatry Physician
  • Sherman Oaks, CA
  • NPI 1326665316
  Medicare reassignment NPD (past)
• Psychiatric Centers at San Diego, Inc. Med GRP

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1841241585
  Medicare reassignment
• Lewis Family Psychiatry, LLC

  • Psychiatry Physician
  • Wellington, FL
  • NPI 1275172892
  NPD

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1801843941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 HALF MOON CIR APT C2",
            "city": "HYPOLUXO",
            "state": "FL",
            "postal_code": "334625494",
            "telephone_number": "515-381-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 WILSHIRE BLVD STE 1705",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900175600",
            "telephone_number": "310-871-0670",
            "fax_number": "619-667-0815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Redwood Hwy Frontage Rd",
            "address_purpose": "LOCATION",
            "city": "Mill Valley",
            "state": "CA",
            "postal_code": "949413034",
            "country_code": "US",
            "telephone_number": "866-247-4292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "credential": "RN NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP11105",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11011940",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN481125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CATAREVAS",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yahaira Young
• Yating Priscilla Young, DDS
• Daniel Youngblood
• Jalen Youngblood
• Jimmesha Youngblood
• Richard Younger
• Lisa Victoria Youngman, PH.D., M.F.T.
• Robert Youngs, L.AC, DIPL. O.M.
• Youngsun Acupuncture & Herbs
• Fountain Dennis Yount, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.