MEDICARE: ALUMITA NAKAUTOGA YOUNG LCSW

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	1041C0700X	Clinical Social Worker	120911	CA

General Provider Information

NPI Number	:	1609632116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALUMITA NAKAUTOGA YOUNG LCSW

Provider Business Mailing Address
First Line	:	18330 HIGHWAY 108
Second Line	:
City	:	JAMESTOWN
State	:	CA
Zip	:	95327-9615
Country	:	US
Telephone Number	:	209-396-5508
Fax Number	:	209-532-3095

Provider Business Practice Location Address
First Line	:	18330 HIGHWAY 108
Second Line	:
City	:	JAMESTOWN
State	:	CA
Zip	:	95327-9615
Country	:	US
Telephone Number	:	209-396-5508
Fax Number	:

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

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	03/07/2024

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