Provider Demographics
NPI:1992587273
Name:YOUNG, SAUNDREA DENISE (LCSW6638)
Entity type:Individual
Prefix:
First Name:SAUNDREA
Middle Name:DENISE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LCSW6638
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3664 W MEDICI LN
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-1883
Mailing Address - Country:US
Mailing Address - Phone:310-259-2541
Mailing Address - Fax:
Practice Address - Street 1:3664 W MEDICI LN
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-1883
Practice Address - Country:US
Practice Address - Phone:310-259-2541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW66381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical