Provider Demographics
NPI:1780051375
Name:DO, PATRICIA GAIL YOUNG (LMFT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GAIL YOUNG
Last Name:DO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:GAIL
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 2713
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95759-2713
Mailing Address - Country:US
Mailing Address - Phone:916-261-8725
Mailing Address - Fax:
Practice Address - Street 1:56 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95203-3100
Practice Address - Country:US
Practice Address - Phone:916-261-8725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT113180106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist