Provider Demographics
NPI:1538682430
Name:SOLDANO, DONNA (MFT, ATR-BC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:SOLDANO
Suffix:
Gender:F
Credentials:MFT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6264 GARDEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95633-9522
Mailing Address - Country:US
Mailing Address - Phone:650-743-3229
Mailing Address - Fax:
Practice Address - Street 1:312 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5698
Practice Address - Country:US
Practice Address - Phone:530-334-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2017-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38068106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist