Active NPI
Healthy Young Minds California PC
Doing business as Healthy Young Minds
- Clinical Child & Adolescent Psychologist
- La Jolla, CA
National Provider Identifier
1962227009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Legal business name
- HEALTHY YOUNG MINDS CALIFORNIA PC
- Doing business as
- Healthy Young Minds
- Practice address
- 7946 Ivanhoe Ave Ste 320
La Jolla, CA 92037-4518 - Phone
- (303) 317-6504
- Fax
- (800) 878-7002
- NPI assigned
- Nov 21, 2024
- Last updated
- Nov 21, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Graf
- Title
- Ceo
- Phone
- (646) 523-5264
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | |||
| Behavior Analyst | 103K00000X | |||
| Psychologist | 103T00000X | |||
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | |||
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Clinical Psychologist | 103TC0700X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | Primary | ||
| Clinical Social Worker | 1041C0700X | |||
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | |||
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | |||
| Child & Adolescent Psychiatry Physician | 2084P0804X | |||
| Art Therapist | 221700000X | |||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
7946 Ivanhoe Ave Ste 320
La Jolla, CA 92037-4518
Mailing address
PO Box 6080
Vail, CO 81658-6080
Phone (303) 317-6504
Other names 1
- Healthy Young Minds
National Provider Directory
National Provider DirectoryLocations
7946 Ivanhoe Ave
Ste 320
La Jolla, CA 92037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732147200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732147200000",
"number": "1962227009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6080",
"city": "VAIL",
"state": "CO",
"postal_code": "816586080",
"telephone_number": "303-317-6504",
"fax_number": "800-878-7002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7946 IVANHOE AVE STE 320",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920374518",
"telephone_number": "303-317-6504",
"fax_number": "800-878-7002"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTHY YOUNG MINDS CALIFORNIA PC",
"organizational_subpart": "NO",
"enumeration_date": "2024-11-21",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A",
"authorized_official_last_name": "GRAF",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "646-523-5264"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0008X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "221700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Art Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Healthy Young Minds",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.