Toni Elizabeth Young-Pen, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 18746 Issued in CA

Practice address

4290 Polk Ave
San Diego, CA 92105-1524

Phone

(619) 563-0507

Fax

(619) 563-0015

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tonielizabeth.youngpen.p1@direct.lamaestra.nextgenshare.com

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.

• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment
• Family Health Centers of San Diego Inc

  • Federally Qualified Health Center (FQHC)
  • Chula Vista, CA
  • NPI 1083959464
  NPD
• Family Health Centers of San Diego Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1528331287
  NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1386689701
  NPD
• La Maestra Family Clinic

  • Federally Qualified Health Center (FQHC)
  • National City, CA
  • NPI 1336324904
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1932297595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3329 NUTMEG ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921045250",
            "telephone_number": "619-807-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 POLK AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051524",
            "telephone_number": "619-563-0507",
            "fax_number": "619-563-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG-PEN",
        "first_name": "TONI",
        "middle_name": "ELIZABETH",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003685",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 18746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "149986",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8939200",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8413932",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandy Basil Younan
• Stephanie Kattoula Younan, PHARMD
• Christine Younes, SLPD, CCC-SLP
• Diana Younes
• Vyanna Lynn Young-Davis
• Allison Young, DTCM, LAC
• Allison Corinne Young
• Amy Young, PT, DPT
• Arlene Rachel Young, PHD
• Barbara Ann Young, DDS

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.