MEDICARE: JASON YOUNG

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1740149053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON YOUNG

Provider Business Mailing Address
First Line	:	81557 DR CARREON BLVD STE C9
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92201-5562
Country	:	US
Telephone Number	:	760-391-6999
Fax Number	:	760-391-6998

Provider Business Practice Location Address
First Line	:	81557 DR CARREON BLVD STE C9
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92201-5562
Country	:	US
Telephone Number	:	760-391-6999
Fax Number	:

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

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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Directions to “ JASON YOUNG ” Practice Location

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