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NPI Code Detail

MEDICARE: MALAYAH WHITE

MEDICARE:   MALAYAH  WHITE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1477404879
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALAYAH WHITE
Provider Business Mailing Address
First Line : 930 S MOUNT VERNON AVE
Second Line :
City : COLTON
State : CA
Zip : 92324-3928
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 930 S MOUNT VERNON AVE
Second Line :
City : COLTON
State : CA
Zip : 92324-3928
Country : US
Telephone Number : 909-660-0097
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 04/06/2026

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Directions to “ MALAYAH WHITE ” Practice Location

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