Provider Demographics
NPI:1457506529
Name:YOUNG-FRIEDMAN, WILLOW (MFT)
Entity Type:Individual
Prefix:
First Name:WILLOW
Middle Name:
Last Name:YOUNG-FRIEDMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:WILLOW
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:22 W MICHELTORENA ST STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-6526
Mailing Address - Country:US
Mailing Address - Phone:805-962-4551
Mailing Address - Fax:805-641-1328
Practice Address - Street 1:22 W MICHELTORENA ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6526
Practice Address - Country:US
Practice Address - Phone:805-962-4551
Practice Address - Fax:805-641-1328
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35824106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist