Healthcare Provider Details

I. General information

NPI: 1427451020
Provider Name (Legal Business Name): L WINTERS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2014
Last Update Date: 08/01/2021
Certification Date: 08/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MARINA VILLAGE PKWY STE 201
ALAMEDA CA
94501-6472
US

IV. Provider business mailing address

PO BOX 583145
ELK GROVE CA
95758-0055
US

V. Phone/Fax

Practice location:
  • Phone: 916-237-9780
  • Fax:
Mailing address:
  • Phone: 916-237-9780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY27193
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberPSY27193
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY27193
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: