Provider Demographics
NPI:1891018388
Name:SUMMERS, DON DOLPH
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:DOLPH
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:DON
Other - Middle Name:DOLPH
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:6950 LUCAS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NICASIO
Mailing Address - State:CA
Mailing Address - Zip Code:94946-9739
Mailing Address - Country:US
Mailing Address - Phone:415-454-5538
Mailing Address - Fax:
Practice Address - Street 1:3195 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2412
Practice Address - Country:US
Practice Address - Phone:415-454-5538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT19184101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health