Active NPI
Carolina Rachel White
- Marriage & Family Therapist
- Hollister, CA
National Provider Identifier
1174698674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 87917
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41957 | Other | CA | UNICARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 87917 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of San Benito Behavioral Health | Current | Accepting new patients | |
| San Benito County | Current | 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.
-
- Case Management Agency
- Hollister, CA
- NPI 1790525871
-
- Clinic/Center
- Hollister, CA
- NPI 1255461471
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.