Provider Demographics
NPI:1154591089
Name:WHITE, CARYN V (MFT)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:V
Last Name:WHITE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 ARCH ST
Mailing Address - Street 2:SEQUOIA COUNSELING SERVICES
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-0383
Mailing Address - Country:US
Mailing Address - Phone:650-363-0249
Mailing Address - Fax:650-363-0436
Practice Address - Street 1:165 ARCH ST
Practice Address - Street 2:SEQUOIA COUNSELING SERVICES
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-0383
Practice Address - Country:US
Practice Address - Phone:650-363-0249
Practice Address - Fax:650-363-0436
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40775106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist