Healthcare Provider Details

I. General information

NPI: 1538312061
Provider Name (Legal Business Name): RHONDA ANTOINETTE WHITE M.A., MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 ROLAND WAY SUITE 150
OAKLAND CA
94621-2034
US

IV. Provider business mailing address

1003 VIEW DR
EL SOBRANTE CA
94803-1249
US

V. Phone/Fax

Practice location:
  • Phone: 510-746-2800
  • Fax:
Mailing address:
  • Phone: 510-385-6378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberIMF81415
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: