MEDICARE: JASON WAYNE YOUNG CADC I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CI30360720	CA

General Provider Information

NPI Number	:	1952873374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON WAYNE YOUNG CADC I

Provider Business Mailing Address
First Line	:	157 E 22ND ST
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95340-3942
Country	:	US
Telephone Number	:	209-421-5372
Fax Number	:

Provider Business Practice Location Address
First Line	:	3522 SANTIAGO CT
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95348-9534
Country	:	US
Telephone Number	:	209-233-8989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/24/2018
Last Update Date	:	03/19/2026

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