Provider Demographics
NPI:1891965760
Name:WINSTON-RUSSELL, GIANA LYNNE
Entity Type:Individual
Prefix:
First Name:GIANA
Middle Name:LYNNE
Last Name:WINSTON-RUSSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GIANA
Other - Middle Name:LYNNE
Other - Last Name:WINSTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6673 CHARLENE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-1616
Mailing Address - Country:US
Mailing Address - Phone:619-750-4040
Mailing Address - Fax:
Practice Address - Street 1:4660 EL CAJON BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-4450
Practice Address - Country:US
Practice Address - Phone:619-597-7335
Practice Address - Fax:619-642-2735
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)