Provider Demographics
NPI:1619031481
Name:WINTERS, GLORIA LINDA (MFT)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:LINDA
Last Name:WINTERS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:GLORIA
Other - Middle Name:LINDA
Other - Last Name:GOLDBAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8350 RESEDA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4619
Mailing Address - Country:US
Mailing Address - Phone:323-848-9771
Mailing Address - Fax:323-650-0824
Practice Address - Street 1:8350 RESEDA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4619
Practice Address - Country:US
Practice Address - Phone:323-848-9771
Practice Address - Fax:323-650-0824
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38825101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional