Nicole Young, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY25364 Issued in CA

Practice address

11650 Iberia PL Ste 130
San Diego, CA 92128-2431

Phone

(801) 935-4171

NPI assigned

Sep 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Fentin-Thompson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Psychiatric Centers at San Diego, Inc. Med GRP

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1841241585
  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1992991079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 IBERIA PLACE",
            "address_2": "#130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92128",
            "telephone_number": "801-935-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 IBERIA PL STE 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282431",
            "telephone_number": "801-935-4171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 Hotel Cir N",
            "address_2": "Suite 450",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921082901",
            "country_code": "US",
            "telephone_number": "619-692-1581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "NICOLE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "FENTIN-THOMPSON",
            "credential": "PSY.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maile Ann Young, MD
• Megan D Young, MSW, ACSW
• Michael Young
• Nathan Christopher Young
• Nelsen William Young, SFIDC
• Nikki Young
• Olivia Grace Young
• Patricia Young, R.N.
• Patricia Beth Young, LCSW
• Rita J Young, MFT INTERN

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.