Provider Demographics
NPI:1043488455
Name:WIND, GINA MARIE (PHD)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:WIND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 CASS ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4509
Mailing Address - Country:US
Mailing Address - Phone:831-464-7707
Mailing Address - Fax:831-464-7707
Practice Address - Street 1:1084 CASS ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4509
Practice Address - Country:US
Practice Address - Phone:831-464-7707
Practice Address - Fax:831-464-7707
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25441103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist