MS. LISA MAE WHITE SUD NPI 1841319092

NPI Information

NPI: 1841319092
Provider Name: MS. LISA MAE WHITE, SUD
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
3340 KEMPER ST
SUITE 105
SAN DIEGO, CA
ZIP 92110
Phone: (619) 523-8121
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MS. Lisa Mae White, SUD is an addiction (substance use disorder) counselor in San Diego, CA. MS. Lisa Mae White, SUD NPI is 1841319092. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3340 KEMPER ST
SUITE 105
SAN DIEGO, CA
ZIP 92110-906
Phone: (619) 523-8121
Fax: (619) 523-8742

The enumeration date for this NPI number is 3/28/2007 and was last updated on 7/17/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	A020360815	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	373781	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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