Healthcare Provider Details

I. General information

NPI: 1851972103
Provider Name (Legal Business Name): YOUNG INTERVENTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8070 SANTA TERESA BLVD STE 120
GILROY CA
95020-3865
US

IV. Provider business mailing address

8070 SANTA TERESA BLVD STE 120
GILROY CA
95020-3865
US

V. Phone/Fax

Practice location:
  • Phone: 408-477-1988
  • Fax: 951-240-3775
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SARAH VILLAR
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 408-710-6508