Healthcare Provider Details

I. General information

NPI: 1407582513
Provider Name (Legal Business Name): LINDSEY WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 COTTLE RD BLDG 24
SAN JOSE CA
95123-3640
US

IV. Provider business mailing address

570 LYTTON AVE
PALO ALTO CA
94301-1542
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-3095
  • Fax:
Mailing address:
  • Phone: 216-410-1286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: