Jeanne Young, Phd, A Psychological Corporation | |
10801 National Blvd Ste 577 Los Angeles CA 90064-4169 | |
(424) 248-7915 | |
(310) 215-9865 |
Full Name | Jeanne Young, Phd, A Psychological Corporation |
---|---|
Speciality | Psychologist |
Location | 10801 National Blvd Ste 577, Los Angeles, California |
Authorized Official Name and Position | Jeanne Young (PRESIDENT) |
Authorized Official Contact | 4242487915 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jeanne Young, Phd, A Psychological Corporation 10801 National Blvd Ste 577 Los Angeles CA 90064-4169 Ph: (424) 248-7915 | Jeanne Young, Phd, A Psychological Corporation 10801 National Blvd Ste 577 Los Angeles CA 90064-4169 Ph: (424) 248-7915 |
NPI Number | 1023311354 |
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Provider Enumeration Date | 12/08/2010 |
Last Update Date | 10/24/2024 |
Certification Date | 10/24/2024 |
Medicare PECOS PAC ID | 2466619978 |
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Medicare Enrollment ID | O20120210000031 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023311354 | NPI | - | NPPES |
PSY119151 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Jeanne Young |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1396760799 PECOS PAC ID: 6507055118 Enrollment ID: I20110113000398 |
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