Provider Demographics
NPI:1578838363
Name:DONLEY, CASANDRA LEE
Entity Type:Individual
Prefix:
First Name:CASANDRA
Middle Name:LEE
Last Name:DONLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15095 AMARGOSA RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-1879
Mailing Address - Country:US
Mailing Address - Phone:760-245-4695
Mailing Address - Fax:760-513-4676
Practice Address - Street 1:14360 SAINT ANDREWS DR
Practice Address - Street 2:SUITE 7
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-4358
Practice Address - Country:US
Practice Address - Phone:760-245-4695
Practice Address - Fax:760-513-4676
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health