Provider Demographics
NPI:1265669733
Name:ATHERTON, DONNA L (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:L
Last Name:ATHERTON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 MURRAY DR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4121
Mailing Address - Country:US
Mailing Address - Phone:619-504-6131
Mailing Address - Fax:
Practice Address - Street 1:676 MURRAY DR
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4121
Practice Address - Country:US
Practice Address - Phone:619-504-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504286363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics