Provider Demographics
NPI:1750091492
Name:WINTON, ERIC T (LMFT 134250)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:T
Last Name:WINTON
Suffix:
Gender:M
Credentials:LMFT 134250
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 WOLVERINE WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8907
Mailing Address - Country:US
Mailing Address - Phone:925-222-7192
Mailing Address - Fax:
Practice Address - Street 1:4307 WOLVERINE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8907
Practice Address - Country:US
Practice Address - Phone:925-222-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT134250101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health