MEDICARE: DR. KATHERINE Y. YOUNG DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E3251	CA
2	213ES0131X	Foot Surgery Podiatrist	E3251	CA

General Provider Information

NPI Number	:	1588771273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE Y. YOUNG DPM

Provider Business Mailing Address
First Line	:	3925 GLEN ABBY CIR
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95219-1802
Country	:	US
Telephone Number	:	209-952-1612
Fax Number	:	209-952-1631

Provider Business Practice Location Address
First Line	:	1810 GRAND CANAL BLVD
Second Line	:	SUITE 2
City	:	STOCKTON
State	:	CA
Zip	:	95207-8110
Country	:	US
Telephone Number	:	209-952-1612
Fax Number	:	209-952-1631

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	09/11/2025

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