Provider Demographics
NPI:1871943316
Name:SUSAN WINSTON PRODUCTIONS INC
Entity type:Organization
Organization Name:SUSAN WINSTON PRODUCTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-567-6589
Mailing Address - Street 1:15707 VARDEN ST
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-3410
Mailing Address - Country:US
Mailing Address - Phone:310-567-6589
Mailing Address - Fax:818-285-8238
Practice Address - Street 1:3500 W OLIVE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4628
Practice Address - Country:US
Practice Address - Phone:818-618-0775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT498640106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty