Provider Demographics
NPI:1669482444
Name:DONATO, JOAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:DONATO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20180 BIG BASIN WAY
Mailing Address - Street 2:
Mailing Address - City:BOULDER CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95006-9005
Mailing Address - Country:US
Mailing Address - Phone:831-338-3952
Mailing Address - Fax:
Practice Address - Street 1:13350 BIG BASIN WAY
Practice Address - Street 2:
Practice Address - City:BOULDER CREEK
Practice Address - State:CA
Practice Address - Zip Code:95006-9237
Practice Address - Country:US
Practice Address - Phone:831-337-7258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical