Individual
JEANETTE R WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 BON AIR ROAD, STE. 105, LARKSPUR, CA 94939
(415) 461-0440
(415) 461-3792
Mailing address
5 BON AIR ROAD, STE. 105, LARKSPUR, CA 94939
(415) 461-0440
(415) 461-3792
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C54743
CA
2080P0203X
Pediatric Critical Care Medicine Physician
D55471
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
945300801
—
MD
Enumeration date
08/13/2006
Last updated
06/03/2015
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