Provider Demographics
NPI:1477211225
Name:WHITE, SARA JUNE (NP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JUNE
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N ROBERTSON BLVD # 662
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1705
Mailing Address - Country:US
Mailing Address - Phone:323-930-2324
Mailing Address - Fax:323-395-5784
Practice Address - Street 1:5901 W OLYMPIC BLVD STE 505
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4670
Practice Address - Country:US
Practice Address - Phone:323-930-2324
Practice Address - Fax:323-930-2497
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95018723363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner