Provider Demographics
NPI:1659655702
Name:WHITE-VOTH, CHARITY (MSW)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:WHITE-VOTH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5421 RIGGS RD
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-1634
Mailing Address - Country:US
Mailing Address - Phone:619-368-3555
Mailing Address - Fax:
Practice Address - Street 1:1107 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-3002
Practice Address - Country:US
Practice Address - Phone:619-368-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW211361041C0700X
CA616191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical