Provider Demographics
NPI:1770116105
Name:YOUNG, TRISHINA YVETTE
Entity type:Individual
Prefix:
First Name:TRISHINA
Middle Name:YVETTE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TRISHINA
Other - Middle Name:YVETTE
Other - Last Name:LITTLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4205 W FIGARDEN DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6051
Mailing Address - Country:US
Mailing Address - Phone:559-221-1680
Mailing Address - Fax:
Practice Address - Street 1:4205 W FIGARDEN DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-6051
Practice Address - Country:US
Practice Address - Phone:559-221-1680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health