Provider Demographics
NPI:1588920789
Name:YOUNG, LA DONNA (LVN)
Entity type:Individual
Prefix:MS
First Name:LA DONNA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 HOWE ST APT 214
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-2294
Mailing Address - Country:US
Mailing Address - Phone:323-791-9796
Mailing Address - Fax:
Practice Address - Street 1:1041 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-3205
Practice Address - Country:US
Practice Address - Phone:818-843-2330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN195821164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse