Individual provider Active NPI

Paul White, B.S., M.A.

  • Marriage & Family Therapist
  • San Luis Obispo, CA
National Provider Identifier
1023567963
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
94615 Issued in CA
Practice address
1129 Marsh St
San Luis Obispo, CA 93401-3323
Phone
(805) 543-7969
NPI assigned
Oct 3, 2016
Last updated
Oct 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 94615 CA Primary

Addresses

Primary practice location

1129 Marsh St
San Luis Obispo, CA 93401-3323

Mailing address

PO Box 192
Grover Beach, CA 93483-0192
Phone (805) 904-0037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119003172 CA Practitioner - Marriage and Family Therapist 5496107971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soultenders IncGroup PAC ID 6507170453, 113 clinicians

Practice addresses (Care Compare)

41 E Foothill Blvd
Suite 102
Arcadia, CA 91006-2361
Phone (626) 701-4249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Master of Arts

State licenses

LicenseStateTypeSpecialty
111578CAMDSocial Worker
94615CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. CurrentSince Jan 8, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Marriage & Family Therapist Current Accepting new patients
Community Counseling Center Past Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 699-9841

Interoperability endpoints

  • Direct secure messaging: paulwhite@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1023567963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934830192",
            "telephone_number": "805-904-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MARSH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013323",
            "telephone_number": "805-543-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "PAUL",
        "credential": "B.S., M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "94615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.