Healthcare Provider Details

I. General information

NPI: 1437014909
Provider Name (Legal Business Name): CIERRA WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5245 CONLEY LN
FAIRFIELD CA
94533-1491
US

IV. Provider business mailing address

1005 J ST APT 356
DAVIS CA
95616-2166
US

V. Phone/Fax

Practice location:
  • Phone: 707-908-9800
  • Fax:
Mailing address:
  • Phone: 480-326-8846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: