Most Relevant Information
Provider Data
| NPI Number: | 1003198441 |
| Provider Name: | CHISANA WHITE |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: | 1558314161 |
Most Important Dates
| Enumeration Date: | 09/12/2011 |
| Last Updated: | 09/12/2011 |
Provider Practice Location
3960 WALNUT DR
EUREKA
CA
955038938
Practice Location Phone/Fax
| Phone: | 7072688722 |
| Fax: |
Provider Mailing Location
3960 WALNUT DR
EUREKA
CA
955038938
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |