Provider Demographics
NPI:1972725257
Name:SMITH-WHITE, KATHERINE DANIELLE (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:DANIELLE
Last Name:SMITH-WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:DANIELLE
Other - Last Name:SMITH-WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10605 BALBOA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6342
Mailing Address - Country:US
Mailing Address - Phone:818-832-2400
Mailing Address - Fax:818-832-2567
Practice Address - Street 1:10605 BALBOA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6342
Practice Address - Country:US
Practice Address - Phone:818-832-2400
Practice Address - Fax:818-832-2567
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA849082084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW809FMedicare ID - Type UnspecifiedEL MONTE
CAW932Medicare ID - Type UnspecifiedHEALTH CENTERS
CAW809BMedicare ID - Type UnspecifiedHUDSON
CAW809AMedicare ID - Type UnspecifiedROYBAL