Provider Demographics
NPI:1477881464
Name:WINBLAD, NEAL E (MFT)
Entity Type:Individual
Prefix:MR
First Name:NEAL
Middle Name:E
Last Name:WINBLAD
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 GLACIER CT S
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4911
Mailing Address - Country:US
Mailing Address - Phone:925-963-9786
Mailing Address - Fax:
Practice Address - Street 1:780 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-3259
Practice Address - Country:US
Practice Address - Phone:925-963-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 28183174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist