Provider Demographics
NPI:1083898043
Name:WHITE, MARGARET HARTLEY (PHD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:HARTLEY
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 SUNNYCREST DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3626
Mailing Address - Country:US
Mailing Address - Phone:714-446-7240
Mailing Address - Fax:714-446-7245
Practice Address - Street 1:1915 SUNNYCREST DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3626
Practice Address - Country:US
Practice Address - Phone:714-446-7240
Practice Address - Fax:714-446-7245
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5096103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY5096OtherMEDICAL LICENSE