Provider Demographics
NPI:1932381712
Name:WINTER, AMBER R (RD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:R
Last Name:WINTER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W BULLARD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612
Mailing Address - Country:US
Mailing Address - Phone:559-628-0552
Mailing Address - Fax:559-793-7278
Practice Address - Street 1:205 W BULLARD
Practice Address - Street 2:SUITE 4
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612
Practice Address - Country:US
Practice Address - Phone:559-628-0552
Practice Address - Fax:559-793-7278
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA943889133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA943889OtherLICENSE