Provider Demographics
NPI:1487994109
Name:WHITE, DALE STEVEN (PHD)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:STEVEN
Last Name:WHITE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10451 E LYLEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-4625
Mailing Address - Country:US
Mailing Address - Phone:559-284-9702
Mailing Address - Fax:
Practice Address - Street 1:10451 E LYLEWOOD WAY
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-4625
Practice Address - Country:US
Practice Address - Phone:559-284-9702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16998103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic