Provider Demographics
NPI:1669780490
Name:WINNETT, LIVIA (MA)
Entity type:Individual
Prefix:
First Name:LIVIA
Middle Name:
Last Name:WINNETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2258 SANTA CLARA AVE
Mailing Address - Street 2:STE 4
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501
Mailing Address - Country:US
Mailing Address - Phone:510-992-3149
Mailing Address - Fax:
Practice Address - Street 1:2258 SANTA CLARA AVE
Practice Address - Street 2:STE 4
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4473
Practice Address - Country:US
Practice Address - Phone:510-992-3149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health