Provider Demographics
NPI:1407923782
Name:STAPP, DONNA (MFT)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:STAPP
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 1:1913 E 17TH ST
Mailing Address - Street 2:#119
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8627
Mailing Address - Country:US
Mailing Address - Phone:714-543-6720
Mailing Address - Fax:714-543-6730
Practice Address - Street 1:1913 E 17TH ST
Practice Address - Street 2:#119
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8627
Practice Address - Country:US
Practice Address - Phone:714-543-6720
Practice Address - Fax:714-543-6730
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC23948101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional