Individual provider Active NPI

Gail M White, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1497741128
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9622 Issued in CA
Practice address
3633 Camino del Rio S
Ste 200
San Diego, CA 92108-4011
Phone
(619) 260-8200
Fax
(619) 260-8288
NPI assigned
Sep 27, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY9622 CA Primary

Addresses

Primary practice location

3633 Camino del Rio S
Ste 200
San Diego, CA 92108-4011

Mailing address

3633 Camino del Rio S
Ste 200
San Diego, CA 92108-4011
Phone (619) 260-8200

Other identifiers 2

IdentifierTypeStateIssuer
00PL96220OtherBCBS
PY00962201MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102000361 CA Practitioner - Psychologist Billing Independently 3779777982 Practice locations: La Mesa, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4700 Spring St
Suite 306
La Mesa, CA 91942-2294
Phone (619) 260-8200

9984 Scripps Ranch Blvd
Suite 127
San Diego, CA 92131-1825

Ste
127 9984 Scripps Ranch Blvd
San Diego, CA 92131-1825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY9622CAMDClinical Psychologist
9622CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1497741128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 CAMINO DEL RIO S",
            "address_2": "STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084011",
            "telephone_number": "619-260-8200",
            "fax_number": "619-260-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 CAMINO DEL RIO S",
            "address_2": "STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084011",
            "telephone_number": "619-260-8200",
            "fax_number": "619-260-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "GAIL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00PL96220",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PY00962201",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.