Healthcare Provider Details

I. General information

NPI: 1740115609
Provider Name (Legal Business Name): MELINDA WHITE PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 MISSION DR
SANTA CRUZ CA
95065-1827
US

IV. Provider business mailing address

236 DARWIN ST
SANTA CRUZ CA
95062-2625
US

V. Phone/Fax

Practice location:
  • Phone: 831-431-0137
  • Fax:
Mailing address:
  • Phone: 831-431-0137
  • Fax: 831-461-3696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELINDA WHITE
Title or Position: PHYSICIAN
Credential: DO
Phone: 831-431-0137