Provider Demographics
NPI:1407502677
Name:DANETTE WINSLOW THERAPY SERVICES
Entity Type:Organization
Organization Name:DANETTE WINSLOW THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANETTE
Authorized Official - Middle Name:JACQUELINE
Authorized Official - Last Name:WINSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:323-333-4759
Mailing Address - Street 1:3848 E COLORADO BLVD STE 21
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-6918
Mailing Address - Country:US
Mailing Address - Phone:323-333-4759
Mailing Address - Fax:
Practice Address - Street 1:3848 E COLORADO BLVD STE 21
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-6918
Practice Address - Country:US
Practice Address - Phone:323-333-4759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1427530195OtherNPI