Provider Demographics
NPI:1639390305
Name:YOUNG, YONIE (L AC)
Entity type:Individual
Prefix:MS
First Name:YONIE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 PETERSBURG CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-3830
Mailing Address - Country:US
Mailing Address - Phone:209-676-0048
Mailing Address - Fax:209-800-8823
Practice Address - Street 1:1625 W MARCH LN STE 101
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6424
Practice Address - Country:US
Practice Address - Phone:209-676-0048
Practice Address - Fax:209-800-8823
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11287171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty