Provider Demographics
NPI:1417240540
Name:GAUDSMITH, DONNA
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:GAUDSMITH
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 1:1330 N INDIAN CANYON DR STE A
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4880
Mailing Address - Country:US
Mailing Address - Phone:760-322-9065
Mailing Address - Fax:760-322-9065
Practice Address - Street 1:1330 N. INDIAN CANYON DR. A
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5528
Practice Address - Country:US
Practice Address - Phone:760-322-9065
Practice Address - Fax:760-322-8916
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)