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General NPI Number Information
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NPI Number | 1548031784
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Entity Type | Individual
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Provider Name | DEJA AMAN WHITE
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Gender | Female
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1955 CITRACADO PKWY STE 300
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City | ESCONDIDO
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State | CA
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Zip | 92029-4113
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Country | US
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Telephone | 760-294-1281
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Fax |
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Provider Business Mailing Address
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Address Line | 2779 W CANYON AVE APT 233
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City | SAN DIEGO
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State | CA
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Zip | 92123-4727
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Country | US
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Telephone | 909-746-6917
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | A-3632706
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License Number State | CA
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