Provider Demographics
NPI:1427272723
Name:YOUNG, DAVID ALLYN (PHD, MPH)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALLYN
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 SAND HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-6468
Mailing Address - Country:US
Mailing Address - Phone:510-864-0714
Mailing Address - Fax:510-864-0714
Practice Address - Street 1:73 SAND HARBOR RD
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94502-6468
Practice Address - Country:US
Practice Address - Phone:510-864-0714
Practice Address - Fax:510-864-0714
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8965103TC0700X
103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical