Laura Mae Young, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

6585TPA Issued in CA

Practice address

1401 Sylvan Ave
Modesto, CA 95355-1367

Phone

(209) 527-6640

Fax

(209) 527-5489

NPI assigned

Nov 8, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kennedy & Young Optometry

  • Optometrist
  • Modesto, CA
  • NPI 1639744238
  NPD (past)
• Kennedy & Young Optometry

  • Optometrist
  • Modesto, CA
  • NPI 1912119942
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1710968698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SYLVAN AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551367",
            "telephone_number": "209-527-6640",
            "fax_number": "209-527-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SYLVAN AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551367",
            "telephone_number": "209-527-6640",
            "fax_number": "209-527-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LAURA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6585TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES",
            "identifier": "16478",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte Aimee Young, MD
• Colette K Young, RPH
• Delores J. Young, RNC, NP
• Hayley Young
• Kylee Ann Young, PA-C
• Nakia Lanae Young
• Nik Anderson Young
• Ricardo B. Young, MD
• Roland I. Young, D.D.S.
• Nadia Yousef, MD

• Optometrist in Modesto, CA
• Providers in Modesto, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.