Provider Demographics
NPI:1972640670
Name:WINEBARGER, MICKI JEAN
Entity type:Individual
Prefix:
First Name:MICKI
Middle Name:JEAN
Last Name:WINEBARGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICKI
Other - Middle Name:JEAN
Other - Last Name:SINCLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:260 COHASSET RD STE 120
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2282
Mailing Address - Country:US
Mailing Address - Phone:530-894-5933
Mailing Address - Fax:530-877-1978
Practice Address - Street 1:260 COHASSET RD STE 120
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2282
Practice Address - Country:US
Practice Address - Phone:530-894-5933
Practice Address - Fax:530-877-1978
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist