Provider Demographics
NPI:1851191530
Name:YOUNG, LAURA (FNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6938 WALLSEY DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-2040
Mailing Address - Country:US
Mailing Address - Phone:619-817-7770
Mailing Address - Fax:
Practice Address - Street 1:1741 EASTLAKE PKWY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-2032
Practice Address - Country:US
Practice Address - Phone:619-482-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine