Provider Demographics
NPI:1134422736
Name:MATHEWS, DON LYLE (MFT)
Entity type:Individual
Prefix:MR
First Name:DON
Middle Name:LYLE
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 SANTA LUCIA DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2338
Mailing Address - Country:US
Mailing Address - Phone:925-280-6700
Mailing Address - Fax:
Practice Address - Street 1:1136 SANTA LUCIA DR
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2338
Practice Address - Country:US
Practice Address - Phone:925-280-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMV 20226106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist