Provider Demographics
NPI:1295713527
Name:YOUNG, JAMIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 DENTON PL
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-3108
Mailing Address - Country:US
Mailing Address - Phone:510-508-0288
Mailing Address - Fax:
Practice Address - Street 1:150 MUIR RD
Practice Address - Street 2:VANCHCS-119
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4668
Practice Address - Country:US
Practice Address - Phone:925-372-2180
Practice Address - Fax:925-372-2169
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist