Provider Demographics
NPI:1518106012
Name:CHEVALIER, DONNA LOUISE (MFT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LOUISE
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 SPRING ST STE 307
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-0274
Mailing Address - Country:US
Mailing Address - Phone:619-328-1341
Mailing Address - Fax:619-328-1354
Practice Address - Street 1:4700 SPRING ST STE 307
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942
Practice Address - Country:US
Practice Address - Phone:619-328-1341
Practice Address - Fax:619-328-1354
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-07
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMC45461106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist