Provider Demographics
NPI:1396832747
Name:LUKES, DONNAJEAN CROCKET (MFT)
Entity Type:Individual
Prefix:MS
First Name:DONNAJEAN
Middle Name:CROCKET
Last Name:LUKES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9530 EAST IMPERIAL HWY
Mailing Address - Street 2:STE M
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242
Mailing Address - Country:US
Mailing Address - Phone:562-803-6545
Mailing Address - Fax:626-335-6044
Practice Address - Street 1:9530 EAST IMPERIAL HWY
Practice Address - Street 2:STE M
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242
Practice Address - Country:US
Practice Address - Phone:562-803-6545
Practice Address - Fax:626-335-6044
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33510106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist