Provider Demographics
NPI:1508239088
Name:YOUNG, ROBERTO MARTINEZ AGUILAR
Entity Type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:MARTINEZ AGUILAR
Last Name:YOUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-3142
Mailing Address - Country:US
Mailing Address - Phone:805-850-8146
Mailing Address - Fax:
Practice Address - Street 1:1849 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-3142
Practice Address - Country:US
Practice Address - Phone:805-850-8146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker