Provider Demographics
NPI:1932750122
Name:WHITE, DOREEN F
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:F
Last Name:WHITE
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 1:233 TOWLE CT
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-2818
Mailing Address - Country:US
Mailing Address - Phone:916-459-7919
Mailing Address - Fax:
Practice Address - Street 1:233 TOWLE CT
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-2818
Practice Address - Country:US
Practice Address - Phone:916-459-7919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)