Individual
SHANETRA L YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
1303 AVOCADO AVE STE 120, NEWPORT BEACH, CA 92660-7840
(949) 386-9794
Mailing address
1303 AVOCADO AVE STE 120, NEWPORT BEACH, CA 92660-7840
(949) 386-9794
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
81202
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81202
LICENSE NUMBER
CA
Enumeration date
08/24/2022
Last updated
08/24/2022
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