Provider Demographics
NPI:1669689501
Name:WINCHELL, JOAN W (MFT)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:W
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12947 VIA ESPERIA
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3722
Mailing Address - Country:US
Mailing Address - Phone:858-755-4167
Mailing Address - Fax:
Practice Address - Street 1:12947 VIA ESPERIA
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3722
Practice Address - Country:US
Practice Address - Phone:858-755-4167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT19243106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist