MEDICARE: DANA ROSE YOUNG LMFT

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	106H00000X	Marriage & Family Therapist	117131	CA

General Provider Information

NPI Number	:	1922853449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA ROSE YOUNG LMFT

Provider Business Mailing Address
First Line	:	30637 HUNT CLUB DR
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-1913
Country	:	US
Telephone Number	:	714-624-4305
Fax Number	:

Provider Business Practice Location Address
First Line	:	27601 FORBES RD
Second Line	:
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1201
Country	:	US
Telephone Number	:	714-624-4305
Fax Number	:

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

Provider Enumeration Date	:	04/18/2024
Last Update Date	:	04/18/2024

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