Provider Demographics
NPI:1548864861
Name:WHITENER, VINEECE FLORABE ROSARIO (CTRS, RTC)
Entity type:Individual
Prefix:
First Name:VINEECE FLORABE
Middle Name:ROSARIO
Last Name:WHITENER
Suffix:
Gender:F
Credentials:CTRS, RTC
Other - Prefix:
Other - First Name:VINEECE FLORABE
Other - Middle Name:ESTILLORE
Other - Last Name:ROSARIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CTRS, RTC
Mailing Address - Street 1:5901 E 7TH ST
Mailing Address - Street 2:BLDG 166 (011-BRC)
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90822-5201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5901 E 7TH ST BLDG 166
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822-5201
Practice Address - Country:US
Practice Address - Phone:562-826-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist