EDGAR T. YOUNG


Address: 4219 Tiburon Dr, Fremont, CA 94555-3261
Phone: 5107947262

EDGAR T. YOUNG (NPI# 1003186818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003186818
Entity Type Individual
Full Name EDGAR T. YOUNG
Credential CADC II, CAS II
Practice Address 4219 Tiburon Dr
Fremont
CA 94555-3261
Practice Telephone 5107947262
Mailing Telephone 5107947262
Enumeration Date 2012-01-10
Last Update Date 2012-01-10
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers

Office Location

Street Address 4219 TIBURON DR
City FREMONT
State CA
Zip Code 94555-3261

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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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Competitor

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City FREMONT
Zip Code 94555

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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