Provider Demographics
NPI:1851813737
Name:WHITE, PATRICIA LOPEZ (LMFT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOPEZ
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 BERNARD ST APT 416
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-5788
Mailing Address - Country:US
Mailing Address - Phone:949-202-6610
Mailing Address - Fax:
Practice Address - Street 1:400 LAKE ST UNIT 209
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5815
Practice Address - Country:US
Practice Address - Phone:949-202-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27930106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist