Claude Young III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1240141216 Issued in CA

Practice address

627 Grant St
Vallejo, CA 94590-7228

Phone

(707) 553-1042

NPI assigned

Apr 29, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• House of Acts

  • Substance Abuse Rehabilitation Facility
  • Vallejo, CA
  • NPI 1326352188
  NPD (past)

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1841811031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 GRANT ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945907228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 GRANT ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945907228",
            "telephone_number": "707-553-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CLAUDE",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1240141216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67574",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "ZGP830392378",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "houseofactsad@comcast.net",
            "affiliation": "N",
            "address_1": "627 Grant St",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945907228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "houseofactsad@comcast.net",
            "affiliation": "N",
            "address_1": "627 Grant St",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945907228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "houseofactsad@comcast.net",
            "affiliation": "N",
            "address_1": "627 Grant St",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945907228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eileen Yoo
• Kimberly Yoo
• Harrison Yoshioka
• Paige Yoshisato, M.D.
• Keith Isamu Yoshizuka, PHARMD
• Clipper Young, PHARMD
• Gina N. Young
• Nicole D Young
• Nicole Kaleen Young, PA-C
• Romi Yount

• Addiction (Substance Use Disorder) Counselor in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.