Provider Demographics
NPI:1083910152
Name:CARRICO, WHITNEY THAYER (MD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:THAYER
Last Name:CARRICO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 BORREGAS AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3018
Mailing Address - Country:US
Mailing Address - Phone:650-856-0622
Mailing Address - Fax:
Practice Address - Street 1:693 BORREGAS AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-3018
Practice Address - Country:US
Practice Address - Phone:650-856-0622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63691282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital