Provider Demographics
NPI:1558117804
Name:YOUNG, JOANNA DARLENE HAW
Entity type:Individual
Prefix:
First Name:JOANNA DARLENE
Middle Name:HAW
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 E DEVONSHIRE AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3083
Mailing Address - Country:US
Mailing Address - Phone:714-953-3563
Mailing Address - Fax:
Practice Address - Street 1:1117 E DEVONSHIRE AVE STE 209
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3083
Practice Address - Country:US
Practice Address - Phone:714-953-3563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program