Provider Demographics
NPI:1922367887
Name:ACKERMAN, DONNA (PSYD , LMFT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:PSYD , LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 CALLE DE PUEBLO
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-5428
Mailing Address - Country:US
Mailing Address - Phone:805-431-9224
Mailing Address - Fax:
Practice Address - Street 1:1035 VINE ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2579
Practice Address - Country:US
Practice Address - Phone:805-431-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY33702103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist