Provider Demographics
NPI:1538283494
Name:WINTER, CATHERINE LIANE (OD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LIANE
Last Name:WINTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1630 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-5102
Mailing Address - Country:US
Mailing Address - Phone:831-443-4422
Mailing Address - Fax:831-443-4516
Practice Address - Street 1:1630 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-5102
Practice Address - Country:US
Practice Address - Phone:831-443-4422
Practice Address - Fax:831-443-4516
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11779T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11779TOtherOPTOMETRY STATE LICENSE
CASDO117790Medicare ID - Type Unspecified
CA11779TOtherOPTOMETRY STATE LICENSE