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General NPI Number Information
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NPI Number | 1194748988
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Entity Type | Individual
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Provider Name | CAROL S. WINETSKY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 3637 SACRAMENTO ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1723
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Country | US
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Telephone | 415-923-9170
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Fax | 415-752-5312
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Provider Business Mailing Address
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Address Line | 150 30TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-1006
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Country | US
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Telephone | 415-923-9170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 6919
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY6919
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License Number State | CA
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