Healthcare Provider Details

I. General information

NPI: 1730430737
Provider Name (Legal Business Name): JEANETTE M WHITE ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2012
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 POST ST STE 526
SAN FRANCISCO CA
94102-1401
US

IV. Provider business mailing address

490 POST ST STE 526
SAN FRANCISCO CA
94102-1401
US

V. Phone/Fax

Practice location:
  • Phone: 415-421-1175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: JEANETTE MELINDA WHITE
Title or Position: OWNER
Credential:
Phone: 415-421-1175