Provider Demographics
NPI:1235228404
Name:WHITE, JEANETTE M (HEARING AID SPECIAL)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:M
Last Name:WHITE
Suffix:
Gender:F
Credentials:HEARING AID SPECIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 TREAT BLVD STE B1
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3601
Mailing Address - Country:US
Mailing Address - Phone:925-288-9500
Mailing Address - Fax:925-288-9502
Practice Address - Street 1:2975 TREAT BLVD
Practice Address - Street 2:SUITE B1
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3601
Practice Address - Country:US
Practice Address - Phone:925-288-9500
Practice Address - Fax:925-288-9502
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA0019050174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist