Provider Demographics
NPI:1912399783
Name:YOUNG, JOANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14445 OLIVE VIEW DR. 1A133
Mailing Address - Street 2:OLIVE VIEW MEDICAL CENTER DEPARTMENT OF PATHOLOGY
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:818-364-3532
Mailing Address - Fax:818-364-4065
Practice Address - Street 1:14445 OLIVE VIEW DR. 1A133
Practice Address - Street 2:OLIVE VIEW MEDICAL CENTER DEPARTMENT OF PATHOLOGY
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:818-364-3532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77360207ZF0201X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology