Provider Demographics
NPI:1093220261
Name:WHYTE, DEBBIE M (BBS/APCC #3628)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:M
Last Name:WHYTE
Suffix:
Gender:F
Credentials:BBS/APCC #3628
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HARVARD AVE UNIT 1364
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-7161
Mailing Address - Country:US
Mailing Address - Phone:909-491-4600
Mailing Address - Fax:
Practice Address - Street 1:2904 W SUNSET BLVD STE 6
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-7308
Practice Address - Country:US
Practice Address - Phone:213-495-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-08
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
18-036221700000X
CA3628101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health