Provider Demographics
NPI:1932883279
Name:WHITE, MARGARYTA (RN, CCM)
Entity Type:Individual
Prefix:
First Name:MARGARYTA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 CAMINO RAMON
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4285
Mailing Address - Country:US
Mailing Address - Phone:925-327-6576
Mailing Address - Fax:925-327-6576
Practice Address - Street 1:2409 CAMINO RAMON
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4285
Practice Address - Country:US
Practice Address - Phone:925-327-6576
Practice Address - Fax:925-327-6576
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645222163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management