Provider Demographics
NPI:1669357208
Name:WINCHESTER, JEFFERY DANIEL (PPS COUNSELOR)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:DANIEL
Last Name:WINCHESTER
Suffix:
Gender:M
Credentials:PPS COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 DATE AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-9214
Mailing Address - Country:US
Mailing Address - Phone:619-668-5720
Mailing Address - Fax:619-668-8305
Practice Address - Street 1:1001 LELAND ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-4819
Practice Address - Country:US
Practice Address - Phone:619-668-5720
Practice Address - Fax:619-668-8305
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA210250043101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool