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General NPI Number Information
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NPI Number | 1558712042
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Entity Type | Individual
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Provider Name | MISS JANEE BREEANNA YOUNG
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Gender | Female
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Dates
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Enumeration Date | 06/25/2016
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Last Update Date | 02/21/2021
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Provider Practice Location Address
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Address Line | 9570 CENTER AVE STE 100
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5842
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Country | US
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Telephone | 909-257-5212
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Fax |
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Provider Business Mailing Address
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Address Line | 9570 CENTER AVE STE 100
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5842
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Country | US
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Telephone | 909-257-5212
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | CA
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