Provider Demographics
NPI:1700418118
Name:YOUNG, ELISANGELA APARECIDA
Entity Type:Individual
Prefix:
First Name:ELISANGELA
Middle Name:APARECIDA
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 PINEHURST AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3933
Mailing Address - Country:US
Mailing Address - Phone:415-913-0748
Mailing Address - Fax:
Practice Address - Street 1:80 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-7303
Practice Address - Country:US
Practice Address - Phone:408-351-6487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator