Provider Demographics
NPI:1659257855
Name:WINTER, THOMAS DAVID (RADT1)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:DAVID
Last Name:WINTER
Suffix:
Gender:M
Credentials:RADT1
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:DAVID
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RADT1
Mailing Address - Street 1:10106 HURLINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-5342
Mailing Address - Country:US
Mailing Address - Phone:661-448-4876
Mailing Address - Fax:
Practice Address - Street 1:5080 CALIFORNIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0794
Practice Address - Country:US
Practice Address - Phone:661-634-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1625120725101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)