MEDICARE: MS. PATRICIA LAYNE WINKS MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	24714	CA

General Provider Information

NPI Number	:	1629188198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA LAYNE WINKS MFT

Provider Business Mailing Address
First Line	:	312 ARGUELLO BLVD
Second Line	:	APT 3
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1437
Country	:	US
Telephone Number	:	415-221-6779
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 ARGUELLO BLVD
Second Line	:	APT 3
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1437
Country	:	US
Telephone Number	:	415-221-6779
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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