Provider Demographics
NPI:1952752271
Name:YOUNGS THERAPY
Entity Type:Organization
Organization Name:YOUNGS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:925-399-6147
Mailing Address - Street 1:6200 STONERIDGE MALL RD
Mailing Address - Street 2:303
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3242
Mailing Address - Country:US
Mailing Address - Phone:925-399-6147
Mailing Address - Fax:925-399-6149
Practice Address - Street 1:6200 STONERIDGE MALL RD
Practice Address - Street 2:303
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3242
Practice Address - Country:US
Practice Address - Phone:925-399-6147
Practice Address - Fax:925-399-6149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51775251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health