Provider Demographics
NPI:1275318917
Name:DONNA, ASIL
Entity Type:Individual
Prefix:
First Name:ASIL
Middle Name:
Last Name:DONNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 COLUMBINE RD
Mailing Address - Street 2:
Mailing Address - City:WEED
Mailing Address - State:CA
Mailing Address - Zip Code:96094-9631
Mailing Address - Country:US
Mailing Address - Phone:530-859-2782
Mailing Address - Fax:
Practice Address - Street 1:1802 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-2808
Practice Address - Country:US
Practice Address - Phone:707-443-7358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program