Provider Demographics
NPI:1962550848
Name:WHITE, MATTHEW STRAUGHN (MS)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:STRAUGHN
Last Name:WHITE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5124 SANICLE WAY
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-4135
Mailing Address - Country:US
Mailing Address - Phone:916-988-6708
Mailing Address - Fax:
Practice Address - Street 1:2120 PROFESSIONAL DR
Practice Address - Street 2:SUITE 220
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3700
Practice Address - Country:US
Practice Address - Phone:916-771-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3733237600000X
CAAU1788231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter