Provider Demographics
NPI:1437170560
Name:DONAHUE, ANGELA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E MEDA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2607
Mailing Address - Country:US
Mailing Address - Phone:626-335-3334
Mailing Address - Fax:626-335-4973
Practice Address - Street 1:150 E MEDA AVE STE 110
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-2607
Practice Address - Country:US
Practice Address - Phone:626-335-3334
Practice Address - Fax:626-335-4973
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14677103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical