Provider Demographics
NPI:1760932297
Name:HAMPTON, WINNTREST R
Entity Type:Individual
Prefix:
First Name:WINNTREST
Middle Name:R
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8275 MARINERS DR APT 288
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-4582
Mailing Address - Country:US
Mailing Address - Phone:209-373-9573
Mailing Address - Fax:
Practice Address - Street 1:400 29TH ST STE 105
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3546
Practice Address - Country:US
Practice Address - Phone:510-268-8120
Practice Address - Fax:510-251-8120
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker