Provider Demographics
NPI:1497898399
Name:MCDONALD, ROY LESLIE (BSC)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:LESLIE
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68855 TORTUGA RD
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-3878
Mailing Address - Country:US
Mailing Address - Phone:760-409-0700
Mailing Address - Fax:
Practice Address - Street 1:1941 S BENSON AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-6003
Practice Address - Country:US
Practice Address - Phone:909-983-7884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor