Healthcare Provider Details

I. General information

NPI: 1316862667
Provider Name (Legal Business Name): CAITLIN WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

696 WHITING ST
GRASS VALLEY CA
95945-7543
US

IV. Provider business mailing address

696 WHITING ST
GRASS VALLEY CA
95945-7543
US

V. Phone/Fax

Practice location:
  • Phone: 530-777-5605
  • Fax: 530-777-5607
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: