Doctor Name: | DR. JOHN R WINSLOW II |
NPI Number: | 1134147416 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PSY 9025 |
Business Practice Address: | 302 Armstrong St Lakeport, CA - 954535202 |
Business Phone Number: | 7072636539 |
Business Fax Number: | |
Mailing Address: | 302 Armstrong St, LAKEPORT |
State: | CA |
Postal Code: | 954535202 |
Phone Number: | 7072636539 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TB0200X |
License Number: | PSY 9025 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Cognitive & Behavioral |
Taxonomy Definition: |