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NPI 1275882169

NPI 1275882169 : LINDA YOUNG-MILLER PH.D. : LIVERMORE, CA

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General NPI Number Information
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    NPI Number           |    1275882169
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    Entity Type          |    Individual 
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    Provider Name        |    LINDA YOUNG-MILLER PH.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/06/2012
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    Last Update Date     |    09/10/2012
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Provider Practice Location Address
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    Address Line         |    1797 4TH STREET DEL VALLE CLINIC
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    City                 |    LIVERMORE
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    State                |    CA
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    Zip                  |    94550
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    Country              |    US
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    Telephone            |    925-443-2500
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1164 CROMWELL STREET 
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    City                 |    LIVERMORE
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    State                |    CA
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    Zip                  |    94551-1724
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    Country              |    US
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    Telephone            |    925-443-2500
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    PSY10263
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    License Number State |    CA
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