Provider Demographics
NPI:1356096739
Name:DONAGHE, CHRIS MICHAEL (NP)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:MICHAEL
Last Name:DONAGHE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 DOVE ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-3909
Mailing Address - Country:US
Mailing Address - Phone:530-953-5095
Mailing Address - Fax:
Practice Address - Street 1:3025 DOVE ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-3909
Practice Address - Country:US
Practice Address - Phone:530-953-5095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020024363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty