Provider Demographics
NPI:1962363051
Name:WINNER, MICHELLE GARCIA (MA)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:GARCIA
Last Name:WINNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4871 TRENT DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-5130
Mailing Address - Country:US
Mailing Address - Phone:408-396-4493
Mailing Address - Fax:408-557-8594
Practice Address - Street 1:1901 S BASCOM AVE STE 340
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2215
Practice Address - Country:US
Practice Address - Phone:408-557-8595
Practice Address - Fax:408-557-8594
Is Sole Proprietor?:No
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7282174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist