Provider Demographics
NPI:1962684134
Name:YOUNG, RENEE L (ND)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:751 BLOSSOM HILL RD STE B2
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3583
Mailing Address - Country:US
Mailing Address - Phone:408-761-6781
Mailing Address - Fax:661-458-3928
Practice Address - Street 1:751 BLOSSOM HILL RD STE B2
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3583
Practice Address - Country:US
Practice Address - Phone:408-761-6781
Practice Address - Fax:661-458-3928
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-26175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath