Provider Demographics
NPI:1235393000
Name:YOUNG, BRIDGET GABRIELLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:GABRIELLE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9308 REDTAIL LN
Mailing Address - Street 2:
Mailing Address - City:PALO CEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:96073-9658
Mailing Address - Country:US
Mailing Address - Phone:530-547-5363
Mailing Address - Fax:530-242-8349
Practice Address - Street 1:2021 BENTON DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003
Practice Address - Country:US
Practice Address - Phone:530-243-2220
Practice Address - Fax:530-242-8349
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10233225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist