Provider Demographics
NPI:1710967450
Name:EMMANUEL, DONNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:EMMANUEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14156 MAGNOLIA BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6410
Mailing Address - Country:US
Mailing Address - Phone:818-907-8232
Mailing Address - Fax:818-905-6686
Practice Address - Street 1:14156 MAGNOLIA BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-6410
Practice Address - Country:US
Practice Address - Phone:818-907-8232
Practice Address - Fax:818-905-6686
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31611106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist