| Jeanne Young, Phd, A Psychological Corporation | |
|
10801 National Blvd Ste 240 Los Angeles CA 90064-4141 | |
| (310) 470-6153 | |
| (310) 215-9865 |
| Full Name | Jeanne Young, Phd, A Psychological Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 10801 National Blvd Ste 240, Los Angeles, California |
| Authorized Official Name and Position | Jeanne Young (PRESIDENT) |
| Authorized Official Contact | 3104706153 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeanne Young, Phd, A Psychological Corporation 10801 National Blvd Ste 240 Los Angeles CA 90064-4141 Ph: (310) 470-6153 | Jeanne Young, Phd, A Psychological Corporation 10801 National Blvd Ste 240 Los Angeles CA 90064-4141 Ph: (310) 470-6153 |
| NPI Number | 1023311354 |
|---|---|
| Provider Enumeration Date | 12/08/2010 |
| Last Update Date | 12/08/2010 |
| Medicare PECOS PAC ID | 2466619978 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396760799 PECOS PAC ID: 6507055118 Enrollment ID: I20110113000398 |
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