Healthcare Provider Details

I. General information

NPI: 1700199643
Provider Name (Legal Business Name): MELINDA LOUISE YOUNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 QUAIL CT #110
WALNUT CREEK CA
94596-8701
US

IV. Provider business mailing address

3527 MT DIABLO BLVD #337
LAFAYETTE CA
94549-3815
US

V. Phone/Fax

Practice location:
  • Phone: 925-944-8880
  • Fax: 925-944-8889
Mailing address:
  • Phone: 925-944-8880
  • Fax: 925-944-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG51085
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG51085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: