Jeanette R White

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C54743 Issued in CA

Practice address

5 Bon Air Road, Ste. 105
Larkspur, CA 94939

Phone

(415) 461-0440

Fax

(415) 461-3792

NPI assigned

Aug 13, 2006

Last updated

Jun 3, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1508878935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BON AIR ROAD, STE. 105",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "94939",
            "telephone_number": "415-461-0440",
            "fax_number": "415-461-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BON AIR ROAD, STE. 105",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "94939",
            "telephone_number": "415-461-0440",
            "fax_number": "415-461-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JEANETTE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MD",
            "license": "D55471",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C54743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945300801",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dora Weber, OTR/L
• Joshua Alex Wechsler, MD
• Bonnie Jill Weiss, LCSW
• Mark P. Wexman, M.D.
• Anne White, OMD
• Morgan Elissa White, MS, LMFT
• Rachel Lea White
• Melanie S Wice, NP RN CNM
• Alexander Widas, BS, LMT, CHT, REV
• Julie Williamson, M.O.T., OTR/L, CHT

• Pediatrics Physician in Larkspur, CA
• Providers in Larkspur, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.