Provider Demographics
NPI:1477238004
Name:WINNER, KAREL (NP)
Entity Type:Individual
Prefix:
First Name:KAREL
Middle Name:
Last Name:WINNER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 RIVERDALE RD # 1182
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-1717
Mailing Address - Country:US
Mailing Address - Phone:650-995-0998
Mailing Address - Fax:
Practice Address - Street 1:1223 CLEVELAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3301
Practice Address - Country:US
Practice Address - Phone:800-303-3221
Practice Address - Fax:541-508-4525
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13394048-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty