Provider Demographics
NPI:1437356078
Name:YOUNG, JUSTIN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:C
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 OAK GROVE AVE
Mailing Address - Street 2:SUITE A201
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:650-838-9888
Mailing Address - Fax:
Practice Address - Street 1:825 OAK GROVE AVE
Practice Address - Street 2:SUITE A201
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4434
Practice Address - Country:US
Practice Address - Phone:650-838-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA925602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry