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General NPI Number Information
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NPI Number | 1093665770
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Entity Type | Individual
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Provider Name | BENJAMIN JACOB YOUNG
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Gender |
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 31 RANCHO CAMINO DR
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City | POMONA
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State | CA
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Zip | 91766-7030
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Country | US
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Telephone | 909-618-0974
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Fax |
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Provider Business Mailing Address
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Address Line | 154 N UKIAH WAY
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City | UPLAND
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State | CA
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Zip | 91786-5854
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Country | US
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Telephone | 909-231-3932
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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