Provider Demographics
NPI:1427026194
Name:WINOGRAD, DEBORAH ROBIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ROBIN
Last Name:WINOGRAD
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 1:34091 CALLE LA PRIMAVERA UNIT B
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2694
Mailing Address - Country:US
Mailing Address - Phone:916-254-8982
Mailing Address - Fax:
Practice Address - Street 1:34091 CALLE LA PRIMAVERA UNIT B
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2694
Practice Address - Country:US
Practice Address - Phone:916-254-8982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11588103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY11588OtherLICENSE NUMBER