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NPI Code Detail

MEDICARE: JEANNE BRACKER WHITE MFT

MEDICARE:   JEANNE BRACKER WHITE  MFT
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
1103K00000XBehavior AnalystMFC 36439CA
2106H00000XMarriage & Family TherapistMFC 36439CA

General Provider Information

NPI Number : 1750711503
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNE BRACKER WHITE MFT
Provider Business Mailing Address
First Line : 4675 VIA LOS SANTOS
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93111-1346
Country : US
Telephone Number : 805-637-5272
Fax Number : 805-964-2722
Provider Business Practice Location Address
First Line : 4675 VIA LOS SANTOS
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93111-1346
Country : US
Telephone Number : 805-637-5272
Fax Number : 805-964-2722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2013
Last Update Date : 11/14/2013

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Directions to “ JEANNE BRACKER WHITE MFT” Practice Location

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