Healthcare Provider Details

I. General information

NPI: 1043528573
Provider Name (Legal Business Name): JENNIFER HUI YOUNG DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 04/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2342 WALSH AVE
SANTA CLARA CA
95051
US

IV. Provider business mailing address

2342 WALSH AVE
SANTA CLARA CA
95051
US

V. Phone/Fax

Practice location:
  • Phone: 408-771-8898
  • Fax: 408-969-0966
Mailing address:
  • Phone: 408-771-8898
  • Fax: 408-969-0966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number31294
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: