NPIMap

Organization Active NPI

California Sprout MC 1 LLC

Doing business as Elemy

  • Behavior Analyst
  • South San Francisco, CA
National Provider Identifier
1902434178
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
CALIFORNIA SPROUT MC 1 LLC
Doing business as
Elemy
Sprout Therapy
Tilly
Practice address
611 Gateway Blvd Ste 120
South San Francisco, CA 94080-7066
Phone
(833) 458-0386
NPI assigned
Apr 1, 2020
Last updated
Jul 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Yury Yakubchyk Sr.
Title
Owner
Phone
(786) 210-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

611 Gateway Blvd Ste 120
South San Francisco, CA 94080-7066

Mailing address

19 W 24TH St FL 4
New York, NY 10010-3239

Other practice location 1

3336 Steiner St
San Francisco, CA 94123-2707
Phone (786) 210-8200

Other practice location 2

333 City Blvd W
Orange, CA 92868
Phone (786) 210-8200

Other names 3

  • Elemy Doing business as
  • Sprout Therapy Doing business as
  • Tilly Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1902434178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 W 24TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100103239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 GATEWAY BLVD STE 120",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940807066",
            "telephone_number": "833-458-0386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3336 Steiner St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941232707",
            "country_code": "US",
            "telephone_number": "786-210-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 City Blvd W",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "92868",
            "country_code": "US",
            "telephone_number": "786-210-8200",
            "fax_number": "929-384-7193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CALIFORNIA SPROUT MC 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-01",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "YAKUBCHYK",
        "authorized_official_first_name": "YURY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-210-8200",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elemy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sprout Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sprout Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tilly",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.