Provider Demographics
NPI:1285799288
Name:WINTERS, STANLEY D (MFT)
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:D
Last Name:WINTERS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 WATT AVE # 150
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-6237
Mailing Address - Country:US
Mailing Address - Phone:916-482-1132
Mailing Address - Fax:916-979-3503
Practice Address - Street 1:2829 WATT AVE # 150
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-6237
Practice Address - Country:US
Practice Address - Phone:916-482-1132
Practice Address - Fax:916-979-3503
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36358106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist