Provider Demographics
NPI:1154494649
Name:WHITE, CAROLINE (LAC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 SANTA MARIA LN
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3227
Mailing Address - Country:US
Mailing Address - Phone:805-886-3532
Mailing Address - Fax:805-569-1277
Practice Address - Street 1:411 E CANON PERDIDO ST
Practice Address - Street 2:SUITE 17
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1550
Practice Address - Country:US
Practice Address - Phone:805-886-3532
Practice Address - Fax:805-569-1277
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9009171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist