Healthcare Provider Details

I. General information

NPI: 1972415891
Provider Name (Legal Business Name): LINDSEY WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 5TH AVE
UPLAND CA
91786-4839
US

IV. Provider business mailing address

436 LA TIENDA DR
BREA CA
92823-6337
US

V. Phone/Fax

Practice location:
  • Phone: 909-949-1980
  • Fax:
Mailing address:
  • Phone: 714-496-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number20354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: