Provider Demographics
NPI:1912451949
Name:WINSTON, AIMEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:WINSTON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N CRESCENT DR STE 130
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-6816
Mailing Address - Country:US
Mailing Address - Phone:310-273-0877
Mailing Address - Fax:
Practice Address - Street 1:415 N CRESCENT DR STE 130
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-6816
Practice Address - Country:US
Practice Address - Phone:310-273-0877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60781775225100000X
CAPT291723225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2087509Medicaid