MEDICARE: JESSICA ROSE WHITE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SZ12322	FL
2	235Z00000X	Speech-Language Pathologist	40239	CA

General Provider Information

NPI Number	:	1205640935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA ROSE WHITE

Provider Business Mailing Address
First Line	:	1452 BLOOMINGDALE AVE
Second Line	:
City	:	VALRICO
State	:	FL
Zip	:	33596-6110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 HOT SPRINGS RD
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93108-2037
Country	:	US
Telephone Number	:	805-969-8011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	04/21/2026

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Directions to “ JESSICA ROSE WHITE ” Practice Location

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