Provider Demographics
NPI:1750507851
Name:DONATI, RICHARD LEE
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LEE
Last Name:DONATI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MAPLE STREET
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637
Mailing Address - Country:US
Mailing Address - Phone:559-675-4515
Mailing Address - Fax:559-675-2157
Practice Address - Street 1:1200 MAPLE STREET
Practice Address - Street 2:SUITE 108
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637
Practice Address - Country:US
Practice Address - Phone:559-675-4515
Practice Address - Fax:559-675-2157
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)