Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY8966 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY8966 | CA |
NPI | 1013083674 |
---|---|
Provider Name | Dr. M D Young |
First Address | San Francisco, CA 94118-3109 |
Second Address | San Francisco, CA 94118-3109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 08/07/2007 |