Provider Demographics
NPI:1437788767
Name:MCDONALD, RAYMOND LATHAN SR
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:LATHAN
Last Name:MCDONALD
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44806 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3213
Mailing Address - Country:US
Mailing Address - Phone:661-234-6212
Mailing Address - Fax:
Practice Address - Street 1:45335 SIERRA HWY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-1611
Practice Address - Country:US
Practice Address - Phone:661-949-8599
Practice Address - Fax:661-723-3179
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)