Provider Demographics
NPI:1629101787
Name:WINTERSTEIN, MICHELE LUCILLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:LUCILLE
Last Name:WINTERSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7119 E MEZZANINE WAY
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-4353
Mailing Address - Country:US
Mailing Address - Phone:562-420-7257
Mailing Address - Fax:
Practice Address - Street 1:4565 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-1507
Practice Address - Country:US
Practice Address - Phone:562-422-8472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 8382103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical