Provider Demographics
NPI:1396885976
Name:CRAIG, DONNA JANE (MA MFT)
Entity type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:JANE
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:158 POINSETTIA AVE
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2308
Mailing Address - Country:US
Mailing Address - Phone:626-277-1003
Mailing Address - Fax:626-441-6479
Practice Address - Street 1:2226 E RIO VERDE DR
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-2067
Practice Address - Country:US
Practice Address - Phone:626-332-1367
Practice Address - Fax:626-441-6479
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA225400000X, 101Y00000X
CA67194101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101Y00000XBehavioral Health & Social Service ProvidersCounselor