Healthcare Provider Details

I. General information

NPI: 1821010273
Provider Name (Legal Business Name): GREGORY LEWIS WHITE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GREGORY HELBICK-WHITE PHD

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 SOUTHAMPTON LANE UNIT A
SANTA CRUZ CA
95062-3468
US

IV. Provider business mailing address

125 SOUTHAMPTON LANE UNIT A
SANTA CRUZ CA
95062-3468
US

V. Phone/Fax

Practice location:
  • Phone: 530-524-0303
  • Fax:
Mailing address:
  • Phone: 530-524-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY8099
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY8099
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY8099
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberPSY8099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: