Individual provider Active NPI

Mary J Youm

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1831613702
Registry record updated Sep 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT127388 Issued in CA
Practice address
298 Grand Ave Ste 100
Oakland, CA 94610-4895
Phone
(510) 463-4461
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT127388 CA Primary

Addresses

Primary practice location

298 Grand Ave Ste 100
Oakland, CA 94610-4895

Mailing address

3545 Harrison St Apt 5
Oakland, CA 94611-5451
Phone (925) 878-5164

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
AMFT127388CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630713600000",
    "number": "1831613702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 HARRISON ST APT 5",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115451",
            "telephone_number": "925-878-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 GRAND AVE STE 100",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104895",
            "telephone_number": "510-463-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUM",
        "first_name": "MARY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2021-09-04",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT127388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2021; 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.