Provider Demographics
NPI:1609932011
Name:WINTON, REBECCA WALSH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:WALSH
Last Name:WINTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8084
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-8084
Mailing Address - Country:US
Mailing Address - Phone:530-566-2223
Mailing Address - Fax:530-433-5680
Practice Address - Street 1:2571 CALIFORNIA PARK DR
Practice Address - Street 2:SUITE 210
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-4042
Practice Address - Country:US
Practice Address - Phone:530-566-2223
Practice Address - Fax:530-433-5680
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19176103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL191760Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST