Provider Demographics
NPI:1457070468
Name:WINNER, LUCAS PAUL
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:PAUL
Last Name:WINNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 NORTHGATE DR APT A
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-1128
Mailing Address - Country:US
Mailing Address - Phone:805-448-5692
Mailing Address - Fax:
Practice Address - Street 1:349 NORTHGATE DR APT A
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-1128
Practice Address - Country:US
Practice Address - Phone:805-448-5692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health