Healthcare Provider Details

I. General information

NPI: 1265378913
Provider Name (Legal Business Name): JANICE C YOUNG RDHAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20885 REDWOOD RD # 348
CASTRO VALLEY CA
94546-5915
US

IV. Provider business mailing address

20885 REDWOOD RD # 348
CASTRO VALLEY CA
94546-5915
US

V. Phone/Fax

Practice location:
  • Phone: 510-909-6763
  • Fax:
Mailing address:
  • Phone: 510-909-6763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberHAP842
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: