Provider Demographics
NPI:1851426761
Name:FUZANE, WINNIE M (MA; MS; AMFT)
Entity Type:Individual
Prefix:MISS
First Name:WINNIE
Middle Name:M
Last Name:FUZANE
Suffix:
Gender:F
Credentials:MA; MS; AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 N ARROWHEAD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1251
Mailing Address - Country:US
Mailing Address - Phone:909-266-2742
Mailing Address - Fax:909-266-2710
Practice Address - Street 1:572 N ARROWHEAD AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401
Practice Address - Country:US
Practice Address - Phone:909-266-2742
Practice Address - Fax:909-266-2710
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113487106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist