Provider Demographics
NPI:1114067584
Name:DOVER, DONNA LYNNE (LCSW, LAADC-CA)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNNE
Last Name:DOVER
Suffix:
Gender:F
Credentials:LCSW, LAADC-CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29525 ROAD 217
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:CA
Mailing Address - Zip Code:93221-9720
Mailing Address - Country:US
Mailing Address - Phone:559-594-8072
Mailing Address - Fax:
Practice Address - Street 1:29525 ROAD 217
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:CA
Practice Address - Zip Code:93221-9720
Practice Address - Country:US
Practice Address - Phone:559-594-8072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 601186001041C0700X
WACP 00005969101YA0400X
CALCI11280418101YA0400X
LCSW710091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)