White, Jeanette R

White, Jeanette R is an individual health care provider with primary practice located at 5 Bon Air Road, Ste. 105 , Larkspur CA 94939. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. White, Jeanette R can be contacted via phone (415) 461-0440.

Contact Information

Primary practice address
5 Bon Air Road, Ste. 105 Larkspur CA 94939
Phone: (415) 461-0440
Fax: (415) 461-3792
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X D55471 Maryland
Allopathic & Osteopathic Physicians / Pediatrics 208000000X C54743 California

Profile Details

NPI number 1508878935
LBN Legal business name White, Jeanette R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Jun 3rd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508878935 NPPES
Maryland MEDICAID 945300801

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