Individual provider Active NPI

Carolina Rachel White

  • Marriage & Family Therapist
  • Hollister, CA
National Provider Identifier
1174698674
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
87917 Issued in CA
Practice address
1131 Community Parkway
San Benito County Behavioral Health
Hollister, CA 95023
Phone
(831) 636-4020
Fax
(831) 636-4025
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Marriage & Family Therapist 106H00000X 87917 CA Primary

Addresses

Primary practice location

1131 Community Parkway
San Benito County Behavioral Health
Hollister, CA 95023

Mailing address

1131 Community Parkway
San Benito County Behavioral Health
Hollister, CA 95023
Phone (831) 636-4020

Other practice location 1

290 I O O F Ave
Gilroy, CA 95020-5204
Phone (408) 310-1358

Other identifiers 1

IdentifierTypeStateIssuer
41957OtherCAUNICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
87917CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Benito Behavioral Health CurrentSince Jun 2, 2024 Accepting new patients
San Benito County CurrentSince Aug 28, 2021 Accepting new patients

Locations

290 Ioof Ave
Gilroy, CA 95020
Phone (408) 846-2148

1131 Community Pkwy
Hollister, CA 95023
Phone (831) 636-4020

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1174698674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 COMMUNITY PARKWAY",
            "address_2": "SAN BENITO COUNTY BEHAVIORAL HEALTH",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "95023",
            "telephone_number": "831-636-4020",
            "fax_number": "831-636-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 COMMUNITY PARKWAY",
            "address_2": "SAN BENITO COUNTY BEHAVIORAL HEALTH",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "95023",
            "telephone_number": "831-636-4020",
            "fax_number": "831-636-4025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 I O O F Ave",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "950205204",
            "country_code": "US",
            "telephone_number": "408-310-1358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CAROLINA",
        "middle_name": "RACHEL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2021-08-19",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "87917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "41957",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollister, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.