Provider Demographics
NPI:1295550556
Name:GARRETT, WHITNEY (CPO, MSOP)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:CPO, MSOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24655 MONROE AVE STE A101
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9587
Mailing Address - Country:US
Mailing Address - Phone:951-691-5000
Mailing Address - Fax:951-691-5443
Practice Address - Street 1:24655 MONROE AVE STE A101
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9587
Practice Address - Country:US
Practice Address - Phone:951-691-5000
Practice Address - Fax:951-691-5443
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPO04126222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist