Provider Demographics
NPI:1477216117
Name:YOUNG, NATASHA JUNE (PA-C)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:JUNE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:29995 TECHNOLOGY DR STE 202
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29995 TECHNOLOGY DR STE 202
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2633
Practice Address - Country:US
Practice Address - Phone:951-698-1118
Practice Address - Fax:951-823-5763
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2022-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA59965363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant