Provider Demographics
NPI:1124414255
Name:HARRIS, DONNA M (MA MARRIAGE FAMILY)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:M
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA MARRIAGE FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 MAIN STREET
Mailing Address - Street 2:UPS STORE, PERSONAL MAIL BOX 295
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076
Mailing Address - Country:US
Mailing Address - Phone:831-227-7533
Mailing Address - Fax:831-647-1498
Practice Address - Street 1:1011 CASS ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4518
Practice Address - Country:US
Practice Address - Phone:831-227-7533
Practice Address - Fax:831-647-1498
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist