Provider Demographics
NPI:1972615375
Name:WHITE, BARBARA ANNE (MS, MFT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANNE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 GOUGH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-7622
Mailing Address - Country:US
Mailing Address - Phone:415-255-5898
Mailing Address - Fax:
Practice Address - Street 1:1010 GOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-7622
Practice Address - Country:US
Practice Address - Phone:415-255-5898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 32200106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA68-0027211Medicare ID - Type Unspecified