Provider Demographics
NPI:1366761744
Name:WEAR, WINNIE L
Entity type:Individual
Prefix:
First Name:WINNIE
Middle Name:L
Last Name:WEAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 SIERRA MADRE VILLA AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-2013
Mailing Address - Country:US
Mailing Address - Phone:626-351-9616
Mailing Address - Fax:626-351-9493
Practice Address - Street 1:650 SIERRA MADRE VILLA AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-2013
Practice Address - Country:US
Practice Address - Phone:626-351-9616
Practice Address - Fax:626-351-9493
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health