Basic Information
| Provider Information | |||||||||
| NPI: | 1154591089 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHITE | ||||||||
| FirstName: | CARYN | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 165 ARCH ST | ||||||||
| Address2: | SEQUOIA COUNSELING SERVICES | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940620383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503630249 | ||||||||
| FaxNumber: | 6503630436 | ||||||||
| Practice Location | |||||||||
| Address1: | 165 ARCH ST | ||||||||
| Address2: | SEQUOIA COUNSELING SERVICES | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940620383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503630249 | ||||||||
| FaxNumber: | 6503630436 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2008 | ||||||||
| LastUpdateDate: | 03/06/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 40775 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.