Individual provider Active NPI

David M. White, PH.D.

  • Clinical Psychologist
  • Santa Monica, CA
National Provider Identifier
1629087887
Registry record updated Mar 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12192 Issued in CA
Practice address
3019 Ocean Park Blvd Ste 360
Santa Monica, CA 90405-3004
Phone
(310) 390-5306
Fax
(310) 441-9343
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2025

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 PSY12192 CA Primary

Addresses

Primary practice location

3019 Ocean Park Blvd Ste 360
Santa Monica, CA 90405-3004

Mailing address

3019 Ocean Park Blvd Ste 360
Santa Monica, CA 90405-3004
Phone (310) 390-5306

Other identifiers 1

IdentifierTypeStateIssuer
PSY121920MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070301000367 CA Practitioner - Clinical Psychologist 2567564024 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Los Angeles, CA 90066
Phone (310) 390-5306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12192CAMDMental Health Counselor
PSY12192CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741996800000",
    "number": "1629087887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 OCEAN PARK BLVD STE 360",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053004",
            "telephone_number": "310-390-5306",
            "fax_number": "310-441-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 OCEAN PARK BLVD STE 360",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053004",
            "telephone_number": "310-390-5306",
            "fax_number": "310-441-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "DAVID",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY121920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.