Provider Demographics
NPI:1205149614
Name:YOUNDT, BETTY J (OD)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:J
Last Name:YOUNDT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13087 CAMINITO DEL ROCIO
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3625
Mailing Address - Country:US
Mailing Address - Phone:858-793-7969
Mailing Address - Fax:
Practice Address - Street 1:13087 CAMINITO DEL ROCIO
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3625
Practice Address - Country:US
Practice Address - Phone:858-793-7969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6444152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist