Robert Eugene White Jr.

Primary specialty

TechnicianTaxonomy code 374700000X

License

173103 Issued in CA

Practice address

1500 Anna Sparks Way
McKinleyville, CA 95519-4170

Phone

(707) 839-0140

Fax

(707) 839-0251

NPI assigned

Jan 20, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1689326613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ANNA SPARKS WAY",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955194170",
            "telephone_number": "707-839-0140",
            "fax_number": "707-839-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ANNA SPARKS WAY",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955194170",
            "telephone_number": "707-839-0140",
            "fax_number": "707-839-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ROBERT",
        "middle_name": "EUGENE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "CA",
            "license": "173103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Elizabeth Weiser, MD
• Jenny Weldon
• Sarah Wennerholm
• Erica Wheeler
• Logan White
• Jane D Williams, M.D.
• Patrick A Williams
• Amy A Williamson, ND
• Glorie Lorrie Williamson, RN
• Windhorse Licensed Clinical Social Workers, P.C.

• Technician in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.