Provider Demographics
NPI:1205126521
Name:DONATI, TOM G (MS)
Entity type:Individual
Prefix:
First Name:TOM
Middle Name:G
Last Name:DONATI
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:GRATTAN
Other - Last Name:DONATI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS MFTI
Mailing Address - Street 1:1911 WILLIAMS DR STE 150
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2612
Mailing Address - Country:US
Mailing Address - Phone:805-981-8460
Mailing Address - Fax:805-981-8461
Practice Address - Street 1:1911 WILLIAMS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:805-981-6830
Practice Address - Fax:805-981-6838
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86494106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist