Provider Demographics
NPI:1144770058
Name:WHITE, CHRISTINA LACROIX (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:LACROIX
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:CHRISTINA
Other - Middle Name:LEIGH
Other - Last Name:LACROIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:450 B ST
Mailing Address - Street 2:SUITE 900
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-4207
Mailing Address - Country:US
Mailing Address - Phone:619-807-0105
Mailing Address - Fax:
Practice Address - Street 1:450 B ST
Practice Address - Street 2:SUITE 900
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-4207
Practice Address - Country:US
Practice Address - Phone:619-807-0105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA657331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical