Provider Demographics
NPI:1346607991
Name:YOUNG, RACHAEL SHERRA (MED, BCBA)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:SHERRA
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:MS
Other - First Name:RACHAEL
Other - Middle Name:S
Other - Last Name:CARLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3861 LAKE CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-7872
Mailing Address - Country:US
Mailing Address - Phone:619-871-1635
Mailing Address - Fax:
Practice Address - Street 1:3861 LAKE CIRCLE DR
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-7872
Practice Address - Country:US
Practice Address - Phone:619-871-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-16-21578103K00000X
CA0-15-6908103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst