SECRET YOUNG (NPI# 1457698474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457698474 |
| Entity Type | Individual |
| Full Name | SECRET YOUNG |
| Credential | MFTI |
| Practice Address |
490 W 14th St Long Beach CA 90813-2943 |
| Mailing Address |
138 Elm Ave Apt 22 Long Beach CA 90802-4925 |
| Practice Telephone | 5625918701 |
| Practice Fax Number | 5625910235 |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2013-01-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
71903 | CA | Behavioral Health & Social Service Providers |
| Street Address |
490 W 14TH ST |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90813-2943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396791463 | Sunbridge Harbor View Rehabilitation Center LLC | Skilled Nursing Facility | 490 W 14th St, Long Beach, CA 90813-2943 | 2006-05-26 |
| 1043777907 | Harborview Center LLC | Community Based Residential Treatment Facility, Mental Illness | 490 W 14th St, Long Beach, CA 90813-2943 | 2019-02-27 |
| 1538610563 | Chi Man Ho | Nurse Practitioner | 490 W 14th St, Long Beach, CA 90813-2943 | 2016-10-14 |
| 1902175433 | Flavia Luresi Sanchez | Rehabilitation Practitioner | 490 W 14th St, Long Beach, CA 90813-2943 | 2011-12-29 |
| 1497024939 | Rosalyn Omoruyi | Rehabilitation Practitioner | 490 W 14th St, Long Beach, CA 90813-2943 | 2011-12-28 |
| 1912289232 | Erin Scott | Counselor | 490 W 14th St, Long Beach, CA 90813-2943 | 2011-09-13 |
| 1336432830 | Saksy Sengamphan | Rehabilitation Practitioner | 490 W 14th St, Long Beach, CA 90813-2943 | 2011-05-17 |
| 1417251752 | Olamae Wells | Rehabilitation Practitioner | 490 W 14th St, Long Beach, CA 90813-2943 | 2010-12-30 |
| 1831499649 | Mary Elizabeth Jakobsen | Counselor | 490 W 14th St, Long Beach, CA 90813-2943 | 2010-10-26 |
| 1710201017 | Chantell Lacy Roberts | Rehabilitation Practitioner | 490 W 14th St, Long Beach, CA 90813-2943 | 2010-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861018491 | Marisol Zobler | Social Worker | 820 Long Beach Bvld, Long Beach, CA 90813 | 2020-06-19 |
| 1437787009 | Cho Rok Kim | Student in an Organized Health Care Education/Training Program | Graduate Medical Education, 1050 Linden Ave., Long Beach, CA 90813 | 2020-03-30 |
| 1316407596 | Vicky Sandhu | Student in an Organized Health Care Education/Training Program | Graduate Medical Education, 1050 Linden Ave, Long Beach, CA 90813 | 2019-03-22 |
| 1245734912 | Madiha Naseem | Internal Medicine | Graduate Medical Education, 1050 Linden Avenue, Long Beach, CA 90813 | 2018-03-19 |
| 1689194508 | Naomi Ruiz | Specialist/Technologist | 838 Pine Ave Apt. 314, Long Beach, CA 90813 | 2017-06-21 |
| 1851831531 | Tyler Lappen | Student in an Organized Health Care Education/Training Program | 830 Atlantic Ave., Long Beach, CA 90813 | 2017-03-01 |
| 1639628886 | Assavuth Kim | Community Health Worker | 1471 Cherry Avenue, Long Beach, CA 90813 | 2016-09-29 |
| 1881031300 | Stacy Nicole Delgado-willis | Marriage & Family Therapist | 851 Pine Ave Ste 103, Long Beach, CA 90813 | 2013-05-23 |
| 1740623453 | Paula Ann Di Thomas | Nurse Practitioner | 1043 Elm Ave #104, Long Beach, CA 90813 | 2013-04-11 |
| 1629322722 | David O Chavez | Case Manager/Care Coordinator | 820 Long Beach Blvd, Long Beach, CA 90813 | 2012-10-29 |
| Find all providers in zip 90813 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851888 | Summer V Vilkins | Counselor | 269 Kennebec Ave Apt 3, Long Beach, CA 90803-5772 | 2020-08-10 |
| 1346875085 | Cherrie-ann K Simon | Counselor | 3503 Linden Ave Apt 207, Long Beach, CA 90807-4532 | 2020-03-03 |
| 1679119507 | Melissa Ann Aguilar | Counselor | 20 W Park Ave Ste 306, Long Beach, NY 11561-2019 | 2019-11-26 |
| 1073154928 | Makando Mutanda | Counselor | 161 West Victoria St., Long Beach, CA 90805 | 2019-10-02 |
| 1477104065 | Sok Khen Kim | Counselor | 841 Gardenia Ave Apt 201, Long Beach, CA 90813-5935 | 2019-09-25 |
| 1174172431 | Sari Klar Mental Health Counseling P.C. | Counselor | 370 W Broadway Apt 6y, Long Beach, NY 11561-3959 | 2019-09-10 |
| 1073175881 | David Coleman | Counselor | 735 West 4th St, Unit D, Long Beach, CA 90802 | 2019-07-01 |
| 1265094155 | Subha Smith | Counselor | 440 E Freeland St Apt 1, Long Beach, CA 90807-2128 | 2019-07-01 |
| 1750941688 | Chanel Samantha Simpson | Counselor | 920 Atlantic Ave Ste 101, Long Beach, CA 90813-4592 | 2019-06-13 |
| 1801455696 | Linda Dianne Ensch | Counselor | 1517 Pacific Ave N, Long Beach, WA 98631-3596 | 2019-06-06 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90813 |
Please comment or provide details below to improve the information on SECRET YOUNG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.