Individual provider Active NPI

Beverly Susan Young, CAS

  • Addiction (Substance Use Disorder) Counselor
  • Rancho Cordova, CA
National Provider Identifier
1902913536
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
03-068573 Issued in CA
Practice address
2801 Aramon Dr
Rancho Cordova, CA 95670-4803
Phone
(916) 429-7977
Fax
(916) 429-7943
NPI assigned
Aug 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 03-068573 CA Primary

Addresses

Primary practice location

2801 Aramon Dr
Rancho Cordova, CA 95670-4803

Mailing address

5340 Finsbury Ave
Sacramento, CA 95841-3817
Phone (916) 334-3003

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
03-068573CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902913536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 FINSBURY AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958413817",
            "telephone_number": "916-334-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ARAMON DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956704803",
            "telephone_number": "916-429-7977",
            "fax_number": "916-429-7943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BEVERLY",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "CAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "03-068573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.