Provider Demographics
NPI:1104832633
Name:WHITE, ELIZABETH RIDLEY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:RIDLEY
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:4067 JENSEN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6205
Mailing Address - Country:US
Mailing Address - Phone:925-200-7922
Mailing Address - Fax:
Practice Address - Street 1:4067 JENSEN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6205
Practice Address - Country:US
Practice Address - Phone:925-200-7922
Practice Address - Fax:925-399-5506
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT28173106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist