Provider Demographics
NPI:1073790796
Name:WINKLER, PENNY (LMFT)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:
Last Name:WINKLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 E 17TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8537
Mailing Address - Country:US
Mailing Address - Phone:714-836-9900
Mailing Address - Fax:714-836-9090
Practice Address - Street 1:1614 E 17TH ST STE D
Practice Address - Street 2:SANTA ANA
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8537
Practice Address - Country:US
Practice Address - Phone:714-836-9900
Practice Address - Fax:714-836-9090
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM15664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health