Provider Information for 1235772682
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MONIQUE L. YOUNG
Sex: Female
NPI: 1235772682
Last Updated: 2023-03-27
Certification Date: 2023-03-27
Certification Date: 2023-03-27
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1235772682 | ||||||||||||
| Enumeration Date | 2019-10-17 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 14320 ANNADALE DR MORENO VALLEY, CA 92555-6238 United States Phone: 951-623-6306 | Fax: | ||||||||||||
| Primary Practice Address | 106 WORTH ST PERRIS, CA 92571-2554 United States Phone: 951-442-1492 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 12968 FREDERICK ST STE D | ||||||||||||
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