Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY17182 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY17182 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY17182 | CA |
NPI | 1598823494 |
---|---|
Provider Name | Dr. Corinne Young |
First Address | Walnut Creek, CA 94596-5318 |
Second Address | Walnut Creek, CA 94596-5318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 11/01/2022 |