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General NPI Number Information
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NPI Number | 1619843950
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Entity Type | Individual
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Provider Name | JASMINE YOUNG
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Gender | Female
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 201 BRUSH ST
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City | UKIAH
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State | CA
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Zip | 95482-3424
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Country | US
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Telephone | 707-462-6290
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Fax |
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Provider Business Mailing Address
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Address Line | 4050 BURKE HILL DR APT 4
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City | UKIAH
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State | CA
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Zip | 95482-9334
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Country | US
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Telephone | 707-989-6221
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Fax | 707-989-6221
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 22592
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License Number State | CA
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