Provider Demographics
NPI:1902921257
Name:WINGATE, DENISE MICHELE (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MICHELE
Last Name:WINGATE
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31915 RANCHO CALIFORNIA RD
Mailing Address - Street 2:SUITES 200-360
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-2998
Mailing Address - Country:US
Mailing Address - Phone:951-378-0660
Mailing Address - Fax:
Practice Address - Street 1:27720 JEFFERSON AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2610
Practice Address - Country:US
Practice Address - Phone:951-506-0864
Practice Address - Fax:951-506-0865
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAMFC50013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health