Individual provider Active NPI

Kelly Christina White, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • Upland, CA
National Provider Identifier
1275113227
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
781110 Issued in CA
Practice address
1260 E Arrow Hwy BLDG E
Upland, CA 91786-4984
Phone
(909) 932-1069
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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 781110 CA
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 781110 CA Primary

Addresses

Primary practice location

1260 E Arrow Hwy BLDG E
Upland, CA 91786-4984

Mailing address

1260 E Arrow Hwy BLDG E
Upland, CA 91786-4984
Phone (909) 932-1069

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
781110CAMDAddiction (Substance Use Disorder) Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Valley Drug and Alcohol Recovery Services CurrentSince Dec 31, 2023 Accepting new patients
Inland Valley Drug and Alcohol Recovery Services CurrentSince Dec 31, 2023 Accepting new patients

Locations

1260 E Arrow Hwy
Bldg E
Upland, CA 91786
Phone 9099321069 ext. 229

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1275113227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 E ARROW HWY BLDG E",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864984",
            "telephone_number": "909-932-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 E ARROW HWY BLDG E",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864984",
            "telephone_number": "909-932-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KELLY",
        "middle_name": "CHRISTINA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "781110",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "781110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.