Provider Demographics
NPI:1275287286
Name:ST. LOUIS, DONALD DAVID (D MIN, MFT)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:DAVID
Last Name:ST. LOUIS
Suffix:
Gender:M
Credentials:D MIN, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2797 PARK AVE.
Mailing Address - Street 2:STE 203
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050
Mailing Address - Country:US
Mailing Address - Phone:415-764-4110
Mailing Address - Fax:
Practice Address - Street 1:2797 PARK AVE
Practice Address - Street 2:STE 203
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050
Practice Address - Country:US
Practice Address - Phone:415-776-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31106106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty