Provider Demographics
NPI:1194748988
Name:WINETSKY, CAROL S (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:S
Last Name:WINETSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1006
Mailing Address - Country:US
Mailing Address - Phone:415-923-9170
Mailing Address - Fax:
Practice Address - Street 1:3637 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1723
Practice Address - Country:US
Practice Address - Phone:415-923-9170
Practice Address - Fax:415-752-5312
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 6919103T00000X
CAPSY6919103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist