Provider Demographics
NPI:1881750057
Name:WHITE -DANLEY, VICKI RAE
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:RAE
Last Name:WHITE -DANLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DOUGLAS DR STE 140
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4078
Mailing Address - Country:US
Mailing Address - Phone:925-405-7138
Mailing Address - Fax:925-313-1142
Practice Address - Street 1:10 DOUGLAS DR STE 140
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4078
Practice Address - Country:US
Practice Address - Phone:252-381-5569
Practice Address - Fax:925-313-1142
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X, 175T00000X
CA373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist