Healthcare Provider Details

I. General information

NPI: 1164348751
Provider Name (Legal Business Name): DR. SANDRA MARIE WHTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5465 EL CAJON BLVD
SAN DIEGO CA
92115-3620
US

IV. Provider business mailing address

4100 NORMAL ST
SAN DIEGO CA
92103-2653
US

V. Phone/Fax

Practice location:
  • Phone: 619-607-5259
  • Fax:
Mailing address:
  • Phone: 619-607-5259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: