Provider Demographics
NPI:1184005035
Name:MATHEWS, DONNA (RN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CALISTOGA
Mailing Address - State:CA
Mailing Address - Zip Code:94515-1135
Mailing Address - Country:US
Mailing Address - Phone:707-812-2038
Mailing Address - Fax:707-942-4260
Practice Address - Street 1:26 VIEW RD
Practice Address - Street 2:
Practice Address - City:CALISTOGA
Practice Address - State:CA
Practice Address - Zip Code:94515-1135
Practice Address - Country:US
Practice Address - Phone:707-812-2038
Practice Address - Fax:707-942-4260
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025381163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult