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General NPI Number Information
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NPI Number | 1346278884
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Entity Type | Individual
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Provider Name | LYNDA LEE WHITE PA
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1616 DA VINCI CT
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City | DAVIS
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State | CA
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Zip | 95616-4860
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Country | US
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Telephone | 530-752-1281
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Fax |
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Provider Business Mailing Address
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Address Line | 2916 25TH ST
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City | SACRAMENTO
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State | CA
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Zip | 95818-3510
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Country | US
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Telephone | 916-455-7083
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA 10514
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License Number State | CA
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