MEDICARE: MS. JEANINE F 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
1	225X00000X	Occupational Therapist	2260	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932472099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEANINE F WHITE

Provider Business Mailing Address
First Line	:	24103 DEL MONTE DR UNIT 432
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91355-3843
Country	:	US
Telephone Number	:	530-701-7786
Fax Number	:

Provider Business Practice Location Address
First Line	:	24103 DEL MONTE DR UNIT 432
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91355-3843
Country	:	US
Telephone Number	:	530-701-7786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2012
Last Update Date	:	02/20/2012

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