Provider Demographics
NPI:1598079055
Name:WINGOOD, OLGA (LMFT)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:WINGOOD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8907 WARNER AVE
Mailing Address - Street 2:#168
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5075
Mailing Address - Country:US
Mailing Address - Phone:949-231-8778
Mailing Address - Fax:
Practice Address - Street 1:8907 WARNER AVE
Practice Address - Street 2:#168
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5075
Practice Address - Country:US
Practice Address - Phone:949-231-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48783106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist