Provider Demographics
NPI:1114445715
Name:YUNG, JESSICA G (PHARMD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:G
Last Name:YUNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2846 OTERO COURT APT 319
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010
Mailing Address - Country:US
Mailing Address - Phone:321-946-0576
Mailing Address - Fax:
Practice Address - Street 1:320 S TWIN OAKS VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-1527
Practice Address - Country:US
Practice Address - Phone:760-471-8019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-02
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH81963183500000X
GARPH030066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist