Provider Demographics
NPI:1497849301
Name:SVANDA, DONNA (MPT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:SVANDA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7364 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-3457
Mailing Address - Country:US
Mailing Address - Phone:707-765-7555
Mailing Address - Fax:
Practice Address - Street 1:599 TOMALES RD
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-5002
Practice Address - Country:US
Practice Address - Phone:707-765-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25567174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist