Provider Demographics
NPI:1932458817
Name:WINTER, SOPHIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:
Last Name:WINTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:SHABAD-RATAN
Other - Middle Name:KAUR
Other - Last Name:KHALSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:3368 SACRAMENTO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1912
Mailing Address - Country:US
Mailing Address - Phone:628-400-6440
Mailing Address - Fax:628-400-6450
Practice Address - Street 1:3368 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1912
Practice Address - Country:US
Practice Address - Phone:628-400-6440
Practice Address - Fax:518-262-6111
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022226103TC0700X
390200000X
CA31735103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program