MEDICARE: DR. SYLVIA T. YOUNG PH.D.

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	103TC0700X	Clinical Psychologist	PSY 7329	CA

General Provider Information

NPI Number	:	1952518037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYLVIA T. YOUNG PH.D.

Provider Business Mailing Address
First Line	:	4925 INDIAN WOOD RD
Second Line	:	#378
City	:	CULVER CITY
State	:	CA
Zip	:	90230-7559
Country	:	US
Telephone Number	:	310-837-4229
Fax Number	:	310-316-2677

Provider Business Practice Location Address
First Line	:	4925 INDIAN WOOD RD
Second Line	:	#378
City	:	CULVER CITY
State	:	CA
Zip	:	90230-7559
Country	:	US
Telephone Number	:	310-837-4229
Fax Number	:	310-316-2677

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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