Provider Demographics
NPI:1043528573
Name:YOUNG, JENNIFER HUI (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:HUI
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 WALSH AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051
Mailing Address - Country:US
Mailing Address - Phone:408-771-8898
Mailing Address - Fax:408-969-0966
Practice Address - Street 1:2342 WALSH AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051
Practice Address - Country:US
Practice Address - Phone:408-771-8898
Practice Address - Fax:408-969-0966
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31294111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA31294OtherDC
CA45-5012651OtherEIN