Provider Demographics
NPI:1508981192
Name:HIRSCHFIELD, DONNA LISBETH (MFT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LISBETH
Last Name:HIRSCHFIELD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 LAKE BLVD
Mailing Address - Street 2:SUITE # 239
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-2614
Mailing Address - Country:US
Mailing Address - Phone:530-756-5313
Mailing Address - Fax:530-756-5313
Practice Address - Street 1:1260 LAKE BLVD
Practice Address - Street 2:SUITE #239
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-2614
Practice Address - Country:US
Practice Address - Phone:530-756-5313
Practice Address - Fax:530-756-5313
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41276106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA358838OtherPIN#