Active NPI
Carmen White
- Community Health Worker
- Culver City, CA
National Provider Identifier
1942768346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 10559 Jefferson Blvd Ste Ade
Culver City, CA 90232-3526 - Phone
- (310) 930-3693
- NPI assigned
- Mar 5, 2019
- Reactivated
- May 29, 2024
- Last updated
- Nov 7, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | NU | Primary | |
| Behavior Technician | 106S00000X | NU |
Addresses
Primary practice location
10559 Jefferson Blvd Ste Ade
Culver City, CA 90232-3526
Mailing address
3626 Vinton Ave Apt 8
Los Angeles, CA 90034-6697
Phone (805) 766-4157
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1942768346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3626 VINTON AVE APT 8",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900346697",
"telephone_number": "805-766-4157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10559 JEFFERSON BLVD STE ADE",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902323526",
"telephone_number": "310-930-3693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "CARMEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-05",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"deactivation_date": "2024-05-09",
"reactivation_date": "2024-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.