Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edna Marie White, RDAT-1R1221770116

Individual provider Substance Abuse Rehabilitation Facility · NPI 1679019152

Edna Marie White, RDAT-1R1221770116 is a Substance Abuse Rehabilitation Facility in Vallejo, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2017

Practice location Address checks out

126 Ohio St
Vallejo, CA 94590-5049
Phone: (707) 644-5577
Fax: (707) 644-5501
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Abuse Rehabilitation Facility (primary) Taxonomy 324500000X · Licence R1221770116 (CA)

Record details

NPI number1679019152
Entity typeIndividual (Type 1)
GenderFemale
Credentials RDAT-1R1221770116
Sole proprietorYes
NPI enumeratedJanuary 9, 2017
Last updated in NPPESJanuary 9, 2017

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