Individual
CALISTA STAR YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
2051 OLD ARCATA RD, BAYSIDE, CA 95524-9033
(707) 599-5508
Mailing address
2051 OLD ARCATA RD, BAYSIDE, CA 95524-9033
(707) 599-5508
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
278
CA
Other
Enumeration date
07/08/2011
Last updated
07/08/2011
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