Healthcare Provider Details

I. General information

NPI: 1447154000
Provider Name (Legal Business Name): MICHAEL CHRISTIAN YOUNG RBT-26-2835314
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 N WINCHESTER BLVD STE 5
SAN JOSE CA
95128-1150
US

IV. Provider business mailing address

259 SUNOL ST UNIT 2
SAN JOSE CA
95126-4803
US

V. Phone/Fax

Practice location:
  • Phone: 408-709-9214
  • Fax:
Mailing address:
  • Phone: 408-667-5184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number2710604
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: