Healthcare Provider Details

I. General information

NPI: 1942695754
Provider Name (Legal Business Name): CHELSEA ANNE YOUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 06/09/2024
Certification Date: 06/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 REDWOOD HWY FRONTAGE RD
MILL VALLEY CA
94941-3034
US

IV. Provider business mailing address

655 REDWOOD HWY FRONTAGE RD STE 261
MILL VALLEY CA
94941-3011
US

V. Phone/Fax

Practice location:
  • Phone: 628-245-3932
  • Fax: 865-205-5228
Mailing address:
  • Phone: 628-245-3932
  • Fax: 865-205-5228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA143800
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA143800
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: