Provider Demographics
NPI:1447315593
Name:YOUNG, JANICE S (MD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:S
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2109
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92531-2109
Mailing Address - Country:US
Mailing Address - Phone:949-999-2941
Mailing Address - Fax:949-999-2942
Practice Address - Street 1:401 OLD NEWPORT BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4291
Practice Address - Country:US
Practice Address - Phone:949-999-2941
Practice Address - Fax:949-999-2942
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG391432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology