Provider Demographics
NPI:1033081484
Name:YOUNG, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1187 COAST VILLAGE RD STE 171
Mailing Address - Street 2:
Mailing Address - City:MONTECITO
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2737
Mailing Address - Country:US
Mailing Address - Phone:805-792-8777
Mailing Address - Fax:
Practice Address - Street 1:675 24TH AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4205
Practice Address - Country:US
Practice Address - Phone:831-475-6323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist